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. LIBRARY
Michigan State This is to certify mat the
Umversuty thesis entitled

 

COMPLETING A NOVEL TASK UNDER DIFFERENT
SENSORY INPUT MODALITY CONDITIONS

presented by
Janelle Mane Rowe

has been accepted towards fulﬁllment
of the requirements for the

Master of degree in Audiology and Speech
Arts Sciences

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Date

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COMPLETING A NOVEL TASK UNDER DIFFERENT SENSORY INPUT
MODALITY CONDITIONS

By

Janelle Marie Rowe

A THESIS
Submitted to
Michigan State University
in partial fulﬁllment of the requirements
for the degree of
MASTER OF ARTS
Department of Audiology and Speech Sciences

2003

ABSTRACT

COMPLETING A NOVEL TASK UNDER DIFFERENT SENSORY INPUT
MODALITY CONDITIONS

By

Janelle Marie Rowe

This study examined if verbal and non-verbal performances on a novel
procedural task were differentially affected by (1.) the sensory modality of
input and (2.) a time delay for displaying learning. One purpose was to
determine if a modality bias existed for the group that received combined
auditory, visual and tactual sensory inputs (AVT) versus the groups that
received only auditory sensory input (A) or combined auditory and visual
sensory inputs (AV). Another purpose was to see if certain modality conditions
enhanced the retention of the new information. This study used 21
Caucasian, male, college students aged 18 to 21 years. It compared the
accuracy of their non-verbal performances and of the procedural discourses
provided by the individuals in each of the experimental groups. For the verbal
performance, results showed a statistically signiﬁcant difference between the
AVT group and the other two groups (A and AV) after the 20-minute time delay
but not before. With respect to the nonverbal performance, the A group
performed significantly poorer than did the other two groups. These results
have implications for future research and clinical work with traumatic brain

injury patients (TBI).

ACKNOWLEDGMENTS

This thesis would not have been possible without the assistance,
encouragement and support from many important people. First, I would like to
thank Dr. Ida Stockman, my thesis chairperson, for providing me with
guidance, direction and encouragement. I would also like to thank my thesis
committee members, Dr. Jeffrey Marler and Dr. Mangala Sadasivan for
providing me with the inspiration to pursue this thesis project.

I would like to acknowledge and thank Ann Bruegger, Allison Pavlat,
and Alicia Wetherall who willingly devoted their time to help analyze the
collected data.

In addition, I would like to express my gratitude to my husband-to-be,
Jeffrey Neal for all of the many roles that he played during the course of this
project. From my cameraman to my computer expert to my personal
cheerleader, he was always there to support, encourage and assist me in any
way possible.

Last, but certainly NOT least, I would like to thank my family for their
ever-constant love, encouragement and faith. Without your support this thesis

would not have been possible. I love you all so much!

TABLE OF CONTENTS

LIST OF TABLES ................................................................................. vii
CHAPTER 1 .
INTRODUCTION TO PROBLEM FOR STUDY ............. 1
Characteristics of TBI ............................................................................. 1
Incidence of TBI ........................................................................... 1
Differential Diagnosis: Aphasia versus TBI .......................................... 2
Symptoms of TBI .......................................................................... 3
Intervention Perspectives ....................................... ' ................................. 8
Neuropsychological Approach ......................................................... 8
Functional Approach ..................................................................... 9
Rationale for the Present Study ............................................................... 11
Event Knowledge as the Root of Intelligent Behavior .......................... 11
Affolter and Bischofberger. The Model of a Root and Learning ............. 14
Theoretical Assumptions of Affolter and Bischofberger’s Model ............ 15
Statement of the Problem ...................................................................... 16
Studies of Children ...................................................................... 17
Studies of Adults ........................................................................ 20
Implementation of the Functional Approach ...................................... 21
Research Questions ............................................................................. 23
CHAPTER 2
METHODS ......................................................................................... 24
Participants ........................................................................................ 24
Description of Participants ............................................................ 24
Participant Selection Criteria.................... ..................................... 24
Participant Selection Procedures ....................... ' ............................ 25
Description of the Experimental Procedures .............................................. 26
Criteria for Task Selection ............................................................ 26
Task Description ........................................ . ............................... 27
Experimental CondItIons ............... 29
Data Collection Procedures29
Description of Task Administration to Experimental Groups ................. 30
Post-Task Survey ................................................................................ 32
Recording of Data ............................................................................... 33
Description of Performance Measures ..................................................... 33
Non-verbal Measure.................... ............................................... 33
Verbal Measure ......................................................................... 34
Scoring of Data ............... . .................................................................... 34
Reliability of Judgments ............................... 35

Statistical Analysis of Data .................................................................... 36

CHAPTER 3

RESULTS .......................................................................................... 37
Quantitative Data Analyses .............................................. - ...................... 3 7
Verbal Performance .............................................................................. 37
Between Groups .................................. ' ...................................... 39
Within Groups ............................................................................ 4O
Nonverbal Performance ........................................................................ 40
Between Group Effects ................................................................ 41
Within Group Effects .................................. 43
Qualitative Data Analysis....‘ .................................................................. 43
Conclusion ......................................................................................... 47
CHAPTER 4
DISCUSSION ..................................................................................... 48
Interpretation ofVerbal Effects ............................................... 50
The Auditory-Verbal Modality Effect ................................................ 50
Tactual versus Visual Modality Effect .............................................. 53
Interpretation of Nonverbal Effects ........................................................... 58
Auditory-Verbal Modality Effects .................................................... 58
Visual and Tactual Modality Effects ..... , ........................................... 59
Implications for Further Research ............................................................ 61
Methodological Limitations in the Present Study ................................ 62
Theoretical Issues ....................................................................... 66
Clinical Implications .............................................................................. 67
Conclusion ......................................................................................... 7O
APPENDICES
‘ Appendix A - Participant Characteristics ................................................... 72
Appendix B - Participant Recruitment Flier ........... . ................................... 74
Appendix C - Participant RecruitmentFlier for COM 100 Students. ........ 75
Appendix D - Participant Background Information ...................................... 76
I Appendix E - Approval to use Human Subjects .......................................... 77
Appendix F — Participant Consent Form .................................................... 78
Appendix G - Steps to Origami Task.................... .................................... 81
Appendix H — Pro-Experiment Demonstration of Vocabulary ......................... 82

Appendix I -— Auditory Group Instructions ................................................... 83

Appendix J - Auditory and Visual Group Instructions ................................ 84

Appendix K - Auditory, Visual, and Tactual Group Instructions ................... 85
Appendix L - Data Collection Sheet ...................................................... 86
Appendix M - Comet Information Unit Calculation Guidelines .................... 87
BIBLIOGRAPHY ............................................................................... 95

' LIST OF TABLES

Table 1 -Steps to origami task .......... . ...................... ...... 28
Table 2 - Group outcomes on verbal performance ................................. 38
Table 3 — Groupoutcomes on nonverbal performance ............................ 41
V Table 4 — Participants' verbatim responses for making the task easier ....... 44
Table 5 — Participants' reports of personal learning type .......... I ............... 46

vii

Chapter One

INTRODUCTION TO PROBLEM FOR STUDY

The current study is motivated by the clinical issues that are related to
the delivery of therapy services to patients with traumatic brain injury (TBI).
TBI is broadly deﬁned as brain injury due to externally inﬂicted trauma. If the
trauma results in the skull with perforation of the meninges, the injury is
considered to be an open-head injury. If the skull and the meninges remain
intact, the injury is considered to be a closed-head injury (JAMA, 1999;
Brookshire, 1997).

Characteristics of TBI
Incidence of TBI

It is estimated that nearly 7 million people in the United States incur
TBIs each year (Rosenthai, 1990). Traumatic brain injuries usually are
associated with motor vehicle accidents, falls, acts of violence, and sports
injuries. “Males are more likely than females to receive TBIs. For 20-year-
olds, the ratio is approximately 4:1 male/female (Brookshire, 1997, p. 326).”
Every year the frequency of TBI occurrence increases. Due to the numerous
negative consequences of TBls for physical, psychological and social
functioning, treatment of these individuals is an important issue for the health
care system (Rosenthal, 1990).

A TBI affects not only young adults. Individuals of all ages are at risk

for sustaining a TBI. Young children (toddlers) and older adults (over 50 years

of age) are at less risk than young adults, but they are still more likely to incur
a TBI than the general population (Brookshire, 1997). The injuries sustained
by young children and older adults are usually a result of a fall, whereas in the
young adult population, the injuries are usually a result of motor vehicle
accidents (Brookshire, 1997). While it is possible for anyone to sustain a
traumatic brain injury, there are certain risk factors that make the probability
greater for some individuals. These risk factors include: the use of alcohol and
drugs, school adjustment and social history, socioeconomic status, personality
type, history of TBI, and participation in sporting activity (Brookshire, 1997;
Rosenthal, 1990).
Differential Diagnosis: ghasia versus TBI

Some may question the need to investigate intervention approaches
and strategies for individuals with a traumatic brain injury. After all, clinicians
have been working with aphasic individuals for decades. Aphasic individuals
too have sustained injury to the brain. How then are individuals with aphasia
different from those individuals who have sustained a TBI? It has been well
documented that in fact, there is a difference between the two types of injuries
(Freund, 1994; Chapey, 1994; Rosenthal, 1990; Gillis, 1996). If aphasic
intervention approaches were sufﬁcient to serve the TBI population, there
would be no need for further research in this area. However, because the
presenting deﬁcits from the injury types differ, perhaps the treatment should

also differ.

Smptoms of TBI

A broad range of symptoms can accompany a TBI. Physical
impairments, such as limited use of limbs, may result from TBI, although the
more problematic consequences involve the individual’s cognition, emotional
functioning, and behavior (JAMA, 1999). According to Ben-Yishay (1983), “it
has been established with virtual certainty that the long-term mental sequelae
outstrip the physical impairments as a cause of difﬁculties with the vocational
and personal rehabilitation of the patient...” (Ben-Yishay, 1983, p. 171). Some
of the most commonly reported neurobehavioral sequelae associated with TBI
include impaired memory, impaired attention and concentration, slowed
information processing, decreased initiation, planning, and organization,
inefﬁcient word recall, tangentiality, diminished self-awareness/self-appraisal,
talkativeness, irritability and restlessness, egocentricity, impulsivity,
disinhibition, dependency, apathy, emotional lability, and depression (Gillis,
1996). In addition, frontal lobe functions, such as the executive skills of
problem solving, abstract reasoning, insight, and judgment also may be
affected when an individual sustains a TBI (JAMA, 1999).

Several studies have explored the different symptoms incurred by
individuals with a TBI. For example, Gronwell and Wrightson (1981) studied a
total of 91 patients in two related studies. All patients were between the ages
of 17-30 years old and had simple head injuries. They looked at deﬁcits of
memory after simple closed head injury and the relation of residual memory

impairment to the duration of post traumatic amnesia (PTA). In the ﬁrst

experiment, 71 subjects were given the Wechsler Memory Scale, the Paced
Auditory Serial Addition Task (PASAT), and the Quick-Test, to get an
approximate verbal IQ. Subjects were grouped by the duration of their PTA.
Subjects in the third group, who had the longest period of PTA, showed a
signiﬁcant Wechsler Memory Quotient (MQ) difference from those in groups
one and two. The analysis of the ﬁrst study suggested different consequences
of simple closed head injury. The ﬁrst could be measured with the PASAT and
seemed to be concerned with attention, concentration, and information
processing capacity. The second consequence clearly involved Ieaming and
memory.

In the ﬁrst experiment Ieaming and memory were weakly related to
PTA; therefore a second experiment was conducted. In this experiment, 20
subjects were given the PASAT, the Selective Reminding Task and the Visual
Sequential Memory subtest from the Illinois Test of Psycholinguistic Abilities.
Thirty normal subjects were also given the two memory tests. The patient
group scored signiﬁcantly below the control group on the visual sequential
memory test. Patients also differed from the controls in their ability to retrieve
material from memory store. The results of the study suggest that closed
head injury has at least three different effects on memory: (1.) a deﬁcit in
information processing, (2.) a reduced ability to place material into long-ten'n
memory store, and (3.) a deﬁcit in the ability to retrieve material from memory

once it has been stored.

In another study of symptoms following TBI, Cicerone and Wood (1987)
observed one 20-year-old male who sustained a severe closed head injury in
a motor vehicle accident four years earlier. This patient demonstrated
impaired planning ability and poor self-control. The ﬁrst two months of
cognitive remediation focused on attention training to decrease distractibility.
After this period, treatment focused on the patient’s planning disorder.

This treatment was based on a modiﬁed self-instructional training
procedure that required the patient to verbalize a plan before and during
execution of the training task and then to gradually fade overt verbalizations.
Before the self-instructional training began, a baseline measure for a therapy
task was attained. During this baseline the patient exhibited ﬁve classes of
target behaviors. These behaviors included 1) self-stimulating verbalizations
(e.g. whistling, singing) during task performance; 2) off-task verbalizations
(e.g. talking about the weather); 3) off-task behaviors; 4) unplanned moves;
and 5) incorrect moves.

During the ﬁrst stage of training there was a 91% decrease in the
number of incorrect moves. Problem solving errors were reduced when the
subjects stated the inappropriate behaviors aloud. Other target behaviors also
showed a systematic reduction over the course of treatment. This treatment
found that when the subjects began to internalize the self-verbalization
strategy, off task behaviors were minimized.

Unlike the focal lesions that often result in aphasia, traumatic brain

injuries result in diffuse neurological damage. This is the reason why so many

different cognitive processes are affected in TBI patients. While a
cerebrovascular accident (CVA) may leave an individual impaired linguistically
in the areas of syntax or phonology, a TBI is more likely to affect an
individual’s use of language or pragmatics (Freund, 1994; Chapey, 1994).

Clients with TBI may have language problems, but these problems are

usually the result of generalized cognitive deﬁcits and are qualitatively

different from those seen in aphasia. The assessment and treatment
principles of aphasia are based on the premise that most cognitive
capacities are intact, whereas the assessment and treatment principles
of TBI are based on the premise that many cognitive abilities are

disturbed. (Freund, 1994, p. 15)

Godfrey, Knight, Marsh, Moroney and Bishara (1989) described the
pragmatic deﬁcits of 18 TBI patients with closed head injuries (CHI). All CHI
subjects had sustained the injury more than 18 months earlier. There was also
a control group that consisted of 18 males with no history of neurological
disorder. The control subjects were matched to the experimental group for
age, years of education, and estimates of pre-morbid IQ. The investigators
examined the relationship between social interaction and speed of information
processing. All subjects took part in a self-assessment of social and emotional
adjustment, a videotaped assessment of social behavior, and a
neuropsychological evaluation. The results of the study showed that the CHI
subjects had an information processing impairment compared to the normal
controls. However, the study did not ﬁnd that the slower information
processing of the CHI subjects was related to their decreased social skills.

It has been well supported that traumatic brain injuries disrupt several

cognitive processes (Rosenthal, 1990; Freund, 1994; Levin, 1992; Gillis, 1996;

Brooks, 1984). Due do these disruptions, both verbal and nonverbal
performances are affected in individuals who incur traumatic brain injuries.
According to the condensed version of Prigatano’s classiﬁcation of cognitive
deﬁcits, there are six main areas of disturbance These include 1.) attention
and concentration, 2.) initiation and goal direction, 3.) judgment and
perception, 4.)leaming and memory, 5.) speed of information processing, and
6.) communication (Rosenthal, 1990). While any combination of these
disturbances can be detrimental to the way an individual functions, the most
practical nonverbal processes affected are those required to complete
activities of daily living (ADLs) (Rosenthal, 1990). One’s ability to perform
ADLs may also be affected if/when the nonverbal processes are taxed to the
point where an individual is unable to solve problems of daily living
independently (Rosenthal, 1990; Gillis, 1996). Many activities that head
injured patients have difﬁculty performing include, but are not limited to
feeding, dressing, personal hygiene skills, transfers, homemaking skills, time
management, ﬁnancial management, and driving (Rosenthal, 1990; Gillis,
1996).

The above cited studies of the literature makes clear that people with
TBIs sustain a range of cognitive deﬁcits that affect both verbal and nonverbal
performances. The question at hand now, is what is the most effective way to
intervene with these patients? This is an especially critical question to ask for
speech-language rehabilitation. This is because speech-language

pathologists have been trained to think primarily about the verbal

performances of their patients. Because TBIs affect both verbal and
nonverbal abilities, intervention that effectively meets patients’ needs must
also inﬂuence nonverbal abilities. To do this, the foundation for therapy should
be cognitively based, in ways that take into account both linguistic and non-
linguistic domains of function. (Rosenthal, 1990; Green, 1997; Kreutzer, 1991).
Intervention Persgctives

Broadly speaking there are two types of competing therapy approaches
in use today for working with individuals with TBls: the neuropsychological
approach, or process speciﬁc approach, and the functional approach.
Neuropsycholggical Approach

The neuropsychological approach is driven by the assumption that the
patient’s overall cognitive functioning will improve by targeting speciﬁc
cognitive areas or functions for remediation (Levin, 1992; Sohlberg & Mateer,
1989; Gillis, 1996). Examples of speciﬁc cognitive processes that might be
addressed include: attention, memory, thought organization, and information
processing (Green, 1997). Sohlberg and Mateer (1989) claim that there are
six fundamental rehabilitation principles that characterize this therapy
approach:

1. A theoretically motivated model deﬁnes each cognitive process

area.
2. Therapy tasks are administered repetitively.
3. Goals and objectives are hierarchically organized.

4. Remediation involves data-based and directed treatment.

5. The use of generalization probes provides measurements of
treatment success.
6. Ultimate measures of success must be improvements in level of
vocational ability and independent living.
To implement or apply the above principles however, tasks are often
administered repetitively. These are usually artiﬁcial tasks that are isolated
from real-life events. For example, one therapy activity may be alternating
between sorting large and small paper clips and sorting colored rubber bands
(Green, 1997). While the underlying goal of the activity (i.e., alternating
attention) is to beneﬁt to the patient’s ability to function in daily life, this type of
activity does not show the patient how to integrate the skill from the isolated
therapy task into a functional task done within a daily living context. It is
assumed that the patient will be able to integrate the skill into a functional task
on his or her own. Unfortunately, this may not happen for some patients,
especially those who are severely impaired. In fact,
clinical observations commonly reveal that performance in sanitized test
situations and improvements in performance in isolated cognitive

processes and systems do not automatically transfer to more functional
tasks in real-world contexts.(Ylvisaker, 1998, p. 136)

Functional Approach

Whereas the neuropsychological or process-speciﬁc therapy approach
is popular for individuals with TBIs, functional therapy is another approach
commonly used with this population (Gillis, 1996; Gruen, 1994;Kreutzer, 1991;
Rosenthal, 1990). Unlike the neuropsychological approach, the functional

approach:

is not limited to skills training in and of itself. Cognitive processes may

be addressed at a component level, but the context in which they are

addressed must take into account the eventual expected activities of

the individual. (Gillis, 1996, p. 147).

This approach requires the patient to integrate the skill(s) in a functional task.
By taking this approach, the patient receives a rich experience in that both
verbal and nonverbal stimulation are received. This approach may be
especially relevant to patients with severe impairment because it may help
them to integrate skills in tasks, thereby making the task environmentally
relevant to the patient.

While the functional therapy approach is being described more
frequently in the literature, there are at least two issues that need to be
addressed before discussing why it is being examined in the current study.
What is meant by functional, and what kind of support exists for its use in a
treatment protocol?

What is functional? Unfortunately, the term “functional” has not been
clearly deﬁned. But it is important to know how “functional" has been deﬁned
by those using such a functional approach to rehabilitation. Proponents of the
functional approach may focus on a list of functional activities or tasks (e.g.,
listening to a story about a hypothetical situation and then responding to
questions about the situation (Gruen, 1994). This is viewed as functional
because these are situations that could present themselves in everyday life.
While the verbal treatment material is about functional events, no assumption

is being made about how the patients are to solve the problems in the actual

situation. They simply answer the questions. The only input the patients

10

receive is auditory verbal. The patients are not “doing” anything during these
tasks.

During these functional tasks, attention is not given to how the patient
should do these tasks. That is, how a task is done is often not a focus of
therapy. Yet the act of doing is implicitly functional. Too often in therapy, the
nonverbal performance on a task is considered as the output or product of the
Ieamed task (i.e., a motor act) and not as a basis for Ieaming. Instead, it is
proposed here that the motor act of “doing" should be viewed as another
source of sensory input for the patient.

This study is broadly motivated by the need to Ieam more about the
functional therapy approach as it may be the preferred mode of treatment for
severe patients. For the purpose of this study, the deﬁnition of functional is an
actual-hands on experience that affects the next sequence of events.

Rationale for the Present Study

It is not enough to just state that doing tasks as part of therapy is
beneﬁcial. Two perspectives, which support the functional approach to
therapy, will be reviewed here. These perspectives provide the theoretical
justiﬁcation for the present study.

Event Knowledge as the Root of Intelligent Behavior

Nelson (1986) argued that event representation is a basic foundation
for both verbal and nonverbal Ieaming. In deﬁning an event, Nelson (1986)
stated that events are about objects and their relationship to the environment.

She claims that events are not static, but that they take place through time.

Stockman (2000) explains events as interactions within the environment that
provide multiple forms of sensory input, including tactual-kinesthetic input.
This input then provides feedback about the cause-effect relationship that
actions have on the environment. The hypothesis on which much of Nelson’s
work is based is “ that the content and structure of knowledge representation
is an important source of observed changes in cognitive functioning” (Nelson,
1986,p.3)

Nelson’s theory ﬁts well with the notion of providing input to a TBI
patient via the act of doing an event. She argues that event knowledge is
central to cognition in young children and adults (Nelson, 1986). By this she
means that children obtain knowledge about the world through direct
experiences with interacting with the environment. This is because they do
not have the same access to new information as older children and adults
(Nelson, 1986). Children cannot Ieam the same way through books, oral
instructions, and television because they do not have the same knowledge of
language as adults and older children (Nelson, 1986). Nelson discusses the
importance of scripts, and how they inﬂuence a child’s language development.

A script is deﬁned as a particular set of action steps that must take
place in a designated sequence in order to achieve a desired outcome.
Verbal and nonverbal scripts for behaving are derived from routine daily life
events (e.g., eating, dressing, etc.). That is, children Ieam scripts from the
routine events of daily living events, which are structured by adult caregivers.

These scripts allow children to create categories for word meanings and

I7

associations with events. Scripts do not pertain to children alone. Nelson
(1996) stated that

With respect to the function of scripts, research with adults has

demonstrated that the event schemas individuals bring to a situation

inﬂuence their interpretation of new experiences, their understanding of
stories and ability to cany on discourse, and enable them to form plans

and make inferences and predictions. (Nelson, 1986, p. 15)

This relates to TBI patients. Depending on the level of severity, they
too may have difﬁculty accessing the knowledge of language that they once
possessed before the injury. Consequently, they would have to regain this
knowledge or at least access to it from direct experience with events. This is
not to say that a patient who sustains a TBI has the same level of functioning
as a child, but rather the assumption is that a brain-damaged individual may
revert to earlier forms of Ieaming. Therefore, the individual’s knowledge can
be reorganized by appealing to the same processes that are needed for
children to develop new knowledge.

Nelson is not the only theorist who supports the idea of “doing” as a
fundamental aspect of organized perceptual cognitive representation of
experiences. Affolter and Bischofberger (2000) also support doing as an
activity providing valuable sensory input to an individual. Tactile experience is

considered the most critical form of input for providing the root of development

for problem solving in one’s environment (Affolter 8r Bischofberger, 2000).

I?

Affolter and Bischofberger: The Model of a Root and Learning

Affolter and Bischofberger (2000) provide a new model of development
that Is rooted by tactile-kinesthetic input. They use the root of a growing tree
and its relationship to the growing branches as a metaphor for describing how
all Ieamers acquire new knowledge. Affolter and Bischofberger (2000) state:

The growth of a tree depends on the growth of its root. When the root

is small as in a young tree, only a few branches are visible. The

stronger the root gets, the stronger the trunk becomes, and the more
branches that will grow. When the root gets sick, the branches get sick
as a consequence. The branches are not related directly to each other;
rather they are related to the root. So their relationship is an indirect

one. Branches represent the levels of development. The growth of a

branch represents the appearance of a given level with its respective

skills. Just as the branches are indirectly related, so are the levels of
development. They are indirectly related through the root. (Affolter &

Bischofberger, 2000, p. 142)

The focus now is, how do Affolter and Bischofberger (2000) relate this
to individuals Ieaming new tasks? They state that the root is responsible for
the growth of the tree. In this analogy, the root represents basic human
experience (i.e., nonverbal interaction/experience in daily life events). Affolter
and Bischofberger deﬁne nonverbal interaction in daily life as “events with
goal-oriented changes in topological relationships between a persons body
engaged in an event and the environment” (Affolter & Bischofberger, 2000, p.
142). This interaction inherently results in causes and effects (i.e., cognitive
processes). Affolter and Bischofberger (2000) claim that as the child
experiences more nonverbal daily interactions with the environment, there is

an improvement in the perceptual organization and cognitive processes.

Affolter and Bischofberger also argue,

IA

that the basic kind of nonverbal interaction experience, which is

represented by the root, requires tactual information. Although vision

and hearing seems to enhance nonverbal interaction activity. (Affolter 8r

Bischofberger, 2000, p. 145)

Affolter and Bischofberger (2000) claim that their model of development
and Ieaming is not only valid for children, it is also valid for adults. They
support this claim with their study of babies and adult patients with brain
damage (Affolter, Bischofberger, 8r Calabretti, 1996). The purpose of their
study was to increase the understanding of brain-damaged patients’ nonverbal
daily interaction deﬁcits by comparing these patients to normal babies interact
with the environment.

The participants were 54 normal babies, ages 0-18 months, and 20
adult patients with TBI, ages 18-70. The babies were observed in daily living
situations such as diaper changing, feeding, and play. The adults were also
observed in daily living situations such as meals, group activities, and helping
in daily needs of the rehabilitation center. The results of their study showed
that the brain-damaged patients showed a level of complexity of nonverbal
interaction units in daily life activities that were similar to that of babies. This
then suggests that the deﬁcits of brain-damaged individuals can help to be
described by what is known about developmental data.

Theoretical Assumptions of Affolter and Bischofberger’s Model

Affolter and Bischofberger came to their model based on four principle
assumptions as summarized by Stockman (2000):

1.) Nonverbal interaction with the physical environment in daily problem-

solving events is the root of development; 2.) Nonverbal interaction is
critically dependent on perceiving information that is anchored by the

1C

tactual-kinesthetic input associated with elicited changes of topological
relationships between the body and the environment; 3.) Inadequate
nonverbal interaction experiences hinder development of nonverbal and
verbal skills when a central nervous system deﬁcit prevents perceptual
activity from being organized well enough to search for the relevant
information; 4.) Inadequate nonverbal interaction experiences can be
impoverished by a variety of central perceptual deﬁcits among children with
language disorders, who are not a homogenous clinical group. (Affolter &
Bischofberger, 2000, p. 197)
Statement of the Problem
While the previous paragraphs have focused on the importance of the
functional approach to therapy, it still remains less well studied than the more
traditional neuropsychological therapy approach. More information is needed
about the functional therapy approach as it may prove beneﬁcial to severe
patients who have the most trouble with activities of daily living (ADLs).
Another reason is the theoretical argument that we need to function at a
foundational level aimed at improving the underlying organization of
perceptual-cognitive ability in TBI patients. To get that foundation, the
, theoretical frameworks above Affolter and Bischofberger in particular, stress
the representation of functional events in which persons participate by moving
their bodies to interact with the world around them. Such activity requires
tactile-kinesthetic perception.
It is assumed that the processes necessary for Ieaming a new task are
basic to all Ieaming at all ages and are not applicable solely to traumatically
brain injured adults, or any kind of injury. Therefore, these same processes

are also applicable to all normal individuals as well, and especially for adults

Ieaming a new task. This is not to say that mature Ieamers do not Ieam tasks

from just auditory-verbal and/or visual input, but that when a task is new, it
may be necessary for them to actually do a new task in order to lay the
foundation for comprehending the associated auditory and visual experiences
in the absence of an action event. This argument justiﬁes the study of normal
adult Ieamers in the present study. Studies of normal adult Ieamers can lay
the groundwork for future studies of clinical populations such as TBI. Studies
of normal adult Ieamers also are important to do because up to now, children
have been typically the focus of research aimed at determining the effect of
“hands-on” experience on Ieaming. The following sections illustrate how some
of these studies have been done with either children or adults.

Studies of Children

Stockman and Latham (2001) observed 15 normal children with the
mean age being 5; 1 yrs. Stockman and Latham investigated whether the
verbal and nonverbal performances of typically developing children who
participated in a novel event would differ from those who only observed the
events visually.

The children Ieamed to do a novel juice-making task. They were
randomly assigned to either an observation group or a participation group.
The observation group listened to and watched a videotape of the examiner
making juice. The participation group was manually guided by the same
examiner to do the task. During the task they heard two nonsense words.
One word represented the action of pressing down on the juicer and the other

word represented the novel object - the antique juicer.

17

The children were then judged on two different measures, a verbal
measure and a nonverbal measure. Performance on the verbal measures
revealed that the children in the auditory/visual group correctly associated the
novel word with the object more often than the participation group; however,
the participation group associated the novel action word with the action more
often than the observation group. A signiﬁcant difference was also found
between the two groups in their verbal answers to questions about the task.
The participation group scored signiﬁcantly better than the observation group.
For the nonverbal performance measure, the children had to reproduce the
task on their own. The participation group scored signiﬁcantly better than the
observation group on this measure. Stockman and Latham (2001) concluded,
that the verbal and nonverbal performances of the typically developing
preschoolers were affected by the modality of sensory input.

Latham and Stockman (2001) also examined whether the same results
would be obtained from children with special needs. The group with special
needs included children with a range of clinical diagnoses inclusive of those
along the spectrum of pervasive developmental delay with a diagnosis of
autism. But the children all exhibited clinically signiﬁcant verbal deﬁcits. The
participants were randomly assigned to an auditory/visual observation group
or to a participation group. The same nonverbal and verbal tasks and
procedures were used as described above for typically developing children.

special needs.

18

When the children’s verbal performance was measured, there was a
signiﬁcantly higher score for the participation group than the observation
group. However, the nonverbal performance measure showed no signiﬁcant
differences between the special needs observation and participation groups in
their ability to reenact the nonverbal task. When compared to the normal
children in the earlier study, it was clear that typically developing children
performed better than the children with special needs on both verbal and
nonverbal tasks. However, the special needs observation group performed
the poorest of all groups. Latham and Stockman’s (2001) ﬁndings suggest
“...that one cannot dismiss the relevance of hands-on experiences, especially
for the special needs child” (Latham & Stockman, 2001 ).

Another study that supported the hands-on approach to intervention
was conducted by Glenburg (2002). Glenburg assessed reading
comprehension and explored how it was affected by the manipulation of
objects. The participants were 33 second grade children. Glenburg divided
the students into three different experimental groups. One group was the
indexical reading approach (IRA) group. Its participants were allowed to
manipulate the objects about which they read. The second group was a non-
manipulate group, and the third group was a classroom control group. All of
the children had to read short stories, but just the children in the IRA group got
to manipulate the objects whereas the children in the other groups did not.

The results showed that the children in the IRA group were able to recall 73%

of the sentences that they read, whereas the children in the non-manipulate
group only recalled 49% of the sentences they had read.

While the 2 previously described studies imply that there is a
connection between tactile-kinesthetic input and performance measures of
different kinds, these studies were done with children; one with normal
children, one with special needs children, and one in which the focus of the
study was reading comprehension. These studies provide reason to suggest
that tactile-kinesthetic input may enhance the performance of adults.

Studies of Adults

The relevant research cited here was done with aphasic patients.
Hinckley (1999) wanted to determine whether there are differential outcomes
of functional and neuropsychological approaches to clinical treatment for
naming deﬁcits among adults with chronic nonﬂuent aphasia. She studied two
groups with 12 adults each. They were comparable in age, post-onset time,
socioeconomic status, and aphasia severity. Hinckley (1999) measured the
subjects’ pre- and post-intervention performances using standardized
measures of language comprehension, naming and functional communication.
These adults also provided a discourse sample and participated in a specially
designed functional task. This task required participants to role-play in a
catalog-ordering scenario.

After 20 hours of therapy for ﬁve weeks, subjects were re-evaluated.
Hinckley (1999) found that those subjects that received functionally based

treatment improved on both the trained task and on a task of oral naming.

rm

Hinckley also found that the cognitive neuropsychologically trained subjects
improved on broad measures of language abilities, including standardized
functional communication assessment and caregiver ratings of
communication.

Although this study examined the differences between the
neuropsychological approach and the functional approach, it was done with
aphasic patients. It is unknown whether such a difference would exist for
patients with traumatic brain injury.

Implementation of the Functional Approach

Lastly, a main component of the functional approach in which more
information is needed, is how therapists are to go about teaching the
functional task. When teaching any task, the input becomes the focus for the
patient and the clinician. This is because the input is all that the clinician has
control over. Clinicians can decide and control what sensory channel the input
is received in, and they can also decide the complexity level of the task. By
default, the sensory channels of choice for clinicians through the years have
usually been vision and audition. For example, when teaching a new task to a
patient, the clinician may say, “I will now tell you how the task is done,” or the
clinician may say, “okay, now watch how I do this,” or ﬁnally, the clinician may
say, “now watch me and do the task at the same time I do it.” While the third
approach stated includes the act of “doing” the task, it often is not the modality
most stressed. Instead, it is believed that the success comes from the visual

input alone and not the collaboration between the two senses.

Some may ask, why the tactile-kinesthetic system is important to
Ieaming? The answer is because it helps one Ieam to know something by
involving his/her body in a direct way. If we look back at the premise of
Affolter and Bischofberger’s (2000), we see that in their framework, function is
deﬁned as “events with goal-oriented changes in topological relationships
between a person who interacts and the environment” (Affolter &
Bischofberger, 2000, p. 142).

Affolter and Bischofberger (2000) have studied patients in hospitals and
clinics all over Europe in order to help them develop their model of
development and Ieaming. However, more research needs to be done in this
area of both atypical and typical populations because much of Affolter and
Bischofberger's argument has been based on theory and indirect empirical
evidence from existing research.

One goal of this study is to test one assumption of Affolter and
Bischofberger’s model, and that is the importance of tactile-kinesthetic input.
In particular, this study will provide empirical data about whether complex
Ieaming improves when it involves tactile-kinesthetic input.

Even though the tactile-kinesthetic system is assumed to provide useful
information, little is known about this system. If this system is, in fact
fundamentally important to human perception and memory involved in doing
functional tasks, then it should be reﬂected in normal persons/Ieamers.
Unfortunately, when asking what is known about normal Ieaming in this

regards, it turns out that little is known about this either. This is because the

’7’)

same biases toward using distance senses for Ieaming and releaming
permeate the literature on normal Ieamers as well. With normal Ieaming
experiments, it is easy to rely on these distance senses because these
persons are assumed to have already stored a rich or elaborate perceptual-
cognitive organization in which distance sensory inputs are connected to body
senses. However, for novel tasks, we might be able to observe a greater
reliance on actual “hands-on” input.
Research Questions
The purpose of this study was to examine whether the verbal and nonverbal
performances of normal adult males on a novel procedural task were
differentially affected by:
1) the sensory modality of input, and

2) the time delay for displaying Ieaming.

23

Chapter Two

METHODS

Participants

Description of Participants

There were 21 participants in the study. They all met the following criteria:
They were male Caucasians, between the ages of 18 and 21. All were
Michigan State University students with normal hearing and no self-reported
history of brain damage or Ieaming disability and had normal or corrected to
normal vision. This information, obtained from participant self-report, is
summarized in Appendix A.

Although 24 persons responded to the request to participate in the
study, 3 of them were excluded because they did not meet the eligibility
requirements. Two of these individuals were female, and one was not within
the pre-speciﬁed age range for the study. Due to time constraints for
completing the project, more participants were not pursued.

Participant Selection Criteria

Twenty-four participants were initially sought to participate in this study.
All participants had to be male, college students, between the ages of 18 and
21 years. In addition, all participants had to have normal hearing, no history of
brain damage or Ieaming disability, and normal or corrected to normal vision.

An additional selection criterion was that none of the participants could have

any previous experience with tasks related to the task in the study, i.e.,
origami. This criterion was important to ensuring that the participants would
Ieam a novel task.

The number of participants had been decided upon based on practical
time constraints for completing the project. The choice of 24 participants was
expected to be minimally adequate for statistical analysis, given the
exploratory pilot nature of this study.

Participant Selection Procedures

want recruiLrnent procedppep. Participants for the study were
recruited using ﬂiers posted at various sites on Michigan State University’s
campus and through the Communication 100 (COM100) class participant pool
through Michigan State University (see Appendix B and C). The recruitment
notice stated that Caucasian, males between the ages of 18 and 21 were
being sought for a research project to be done in the Communication Arts and
Sciences building. The recruitment notice also contained contact information
for reaching the examiner. Contact information included the examiner’s name,
email address, and home telephone number. The ﬂier clearly stated that the
participants in the study would be reimbursed for their time at a rate of $12.00
an hour or they could choose to receive class credit for COM 100 if they were
enrolled in that course. Once the participants contacted the examiner, they
undenNent a further level of screening.

P_artickﬁnt screening procedures. During the screening process the

participants were asked to provide a written self-report of basic identiﬁcation

information that included: their name, the ethnic group they identiﬁed with,
their age, their major, whether there was a history of brain damage or Ieaming
disability, if their hearing was within normal limits and if their vision was within
normal limits or corrected to within normal limits. In addition, the participants
were also asked about previous experiences with origami (see Appendix D).

Human participant assurances. The participants in this study were not
endangered at any time. The procedure was designed to ensure the
participants’ safety during the experiment, and it had been approved by the
University Committee on Research Involving Human Subjects (see Appendix
E). All information obtained from the participants has been kept conﬁdential
by assigning each participant a number that was used for purposes of data
analysis.

All participants provided informed written consent before beginning the
research study (see Appendix F). The participants were informed that their
participation was completely voluntary and they could withdraw from the study
at anytime.

Description of the Exgrimental Procedures
Criteria for Task Selection

Before describing what the experimental task was, I should explain
what type of task was selected. The examiner wanted to select a novel task
that would be challenging to normal Ieamers with a lot of prior everyday
problem-solving experiences. It also had to be possible to Ieam the task using

either one or a combination of sensory modalities within a reasonable amount

of time. In addition, the task had to be a procedural task. The reason for
choosing a procedural task was that its step-like approach for completion
could correspond to problem solving tasks in the work place. Performance of
job tasks is an area of concern for individuals with Traumatic Brain Injuries
(TBls). As mentioned in the previous chapter, many such individuals (i.e.,
people with TBls) are often young adults and of working age. So any
treatment must be geared toward helping them to return to work or school
successfully.

Task description

Taking all of the above criteria into account, the task chosen for this
experiment was a paper-folding task, more speciﬁcally, an origami task. The
word origami comes from the Japanese language and means folded paper.
Because the difﬁculty level can vary, this type of task meets all of the task
selection criteria.

For this study, the task of an origami card case with a difﬁculty level of
very easy was chosen. The level of very easy represented the judgment of
one author of a book about origami. The task used in this study was taken
from the book mga_mi (Gross, 2001). Although the task used was judged to
be very easy, it should be noted that to someone unfamiliar with origami the
task of making an origami card case would present a challenge. The steps

required for the task are shown in Table 1.

0'7

 

 

Table 1. Steps to Origpmi Tﬁk
Steps to Origami Task

1. Position the paper vertically in front of you.

2. Fold the paper in half, bringing the top to the bottom and crease.

3. Take the top ﬂap and fold the paper up to the crease and crease the
fold.

4. Unfold

5. Turn the paper over.

6. Take the top ﬂap and fold the paper up to the crease and crease the
fold.

7. Unfold

8. Take the bottom left comer and fold it up to the crease in the middle
of the page.

9.

 

14.
15.
16.
17.

Repeat the previous step with the remaining three corners.

10. Fold the top ﬂap along the middle crease.
11 .Turn the paper over.

12.Fold the top ﬂap along the middle crease.
13.

Take the top ﬂap and fold it up, creating a rectangle with a ﬂat
surface.

Turn the paper vertically.

Make a one-inch fold at the top of the paper, creating two pockets.
Insert the bottom comers into the pockets.

Fold the paper in half, bringing the left side over to the right.

 

These same steps were provided verbatim to the participants (see Appendix

G).

The paper used in this origami task was a type of paper typically used

for charcoal drawings. The sheets were 9”x12” with a weight of 95 g/m2. The

sheets were off-white in color and had a textured surface. A textured surface

was used because it was judged to provide more tactual input than smooth

paper.

 

Exmrimental Conditions

Participants were randomly assigned to one of three experimental
groups. The participants of each group Ieamed the experimental task under
one of three input conditions. These included: 1.) Auditory input, 2.) Auditory
and visual input, and 3.) Auditory, visual and tactual input.

Having received information about how to do the task in the Ieaming
phase of the experiment, participants’ retention was assessed immediately
after completion of the initial instructions and after a 20-minute time interval.
During this time interval the participants engaged in a distraction task, which
required them to search for hidden words.

Data Collection Procedures

Administration conditions. The data were collected in a laboratory-like
setting at Michigan State University. The room was part of the early language
laboratory located in the basement of the Communication Arts and Sciences
building. The data collection took place on three separate occasions over a
time period of one month. Participants from each group were randomly tested
on each of the three separate data collection occasions.

Instructions for doing the task. All of the participants received
instructions for the task in the same room. Only one participant was present at
a time. Before beginning the experiment, each participant had to demonstrate
understanding of vocabulary that was to be used in the study (see Appendix

H). Each participant also received speciﬁc instructions, which were provided

29

both auditorily and visually, as to what he was to do for the task (See
Appendix I, J, K).
Description of Task Administration to Exgrimental Groups

A detailed explanation of how the task was administered to each of the
three test groups follows.

m. This group received instructions via auditory-verbal input. The
auditory input was standardized across participants by using a pre-recorded
audio tape of a female voice reading the steps to complete the task. The
words that were used on the tape are the same words that can be found in
Appendix G. After a step was read, there was a two second pause, and then
the same step was repeated two more times. Each time the repeated
presentation was separated by a two second pause. This ensured that the
participants in this experimental group were offered as much opportunity to
experience as much input as the participants in the other input conditions.
After the participants listened once to all of the instructions, the examiner
presented the task again in the same manner used for the ﬁrst presentation.
After the second presentation of the steps for the task, the participants
attempted to perform the task by themselves with no further input from the
examiner. After this performance, participants were asked to provide
procedural discourse, or in other words, describe how they would instruct
someone else on how to complete the task they had just done.

After that, the participants were escorted into another room where they

took part in a word search task for 20 minutes. This distraction task was

chosen because it was assumed to be unrelated to the experimental task at
hand. By participating in the distraction task, subjects were not able to practice
the experimental task in the time before demonstrating what they had Ieamed.
Following the 20 minutes, the participants returned to the original room to
attempt the task again. And again, after performing the task, or attempting to,
the participants had to provide procedural discourse.

G_ro_pp_2_. The participants received instructions via auditory-verbal input
as described above; in addition, they also received visual input. The examiner
and the subjects (one at a time) were seated side by side at a table. The
examiner performed the task as the participant looked on. This group
received the same tape- recorded instructions that the auditory-verbal group
received. After an auditory-verbal instruction was given, however, the
participants in this group also saw the step performed by the examiner. After
all of the steps for the task were given to the participants, the process was
repeated again in the same manner as the ﬁrst presentation. After the second
presentation of auditory and visual input about how to do the task, the
participants attempted the task on their own with no further input from the
examiner. This group also had to provide procedural discourse.

After that, the participants were escorted to another room just like group
one and they took part in the same distraction task. Also like group one, after
20 minutes, the participants returned to the original room to perform both the

verbal and non-verbal components of the task.

M. This group received instructions via auditory-verbal, visual, and
tactile input. This group listened to the same tape-recorded message as the
two previously described groups. The participants in this group also received
the visual input from the examiner seated next to them, but instead of just
watching the examiner demonstrate each step, the participants in this group
were asked to perform the steps at the same time the examiner was
demonstrating them. After all of the steps were shown to the participants, the
instructions were repeated in the same manner as the ﬁrst presentation. After
the second presentation of auditory, visual and tactual input about how to do
the task, the participants attempted the task on their own with no further input
from the examiner. This group, like both groups previously described, also
provided procedural discourse.

After doing so the participants were then escorted to another room to
take part in a 20-minute distraction task. Following the 20 minutes, the
participants returned to the original room to again perform both the verbal and
non-verbal components of the task.

Post-Task Survey

After the participants engaged in the experimental task for the second
time (i.e., following the distraction task), they were asked to orally respond to
three questions about the task. The ﬁrst question required them to rate on a
scale of 1 to 5 how comfortable they were in their ability to correctly complete
the task. On a scale of 1 — 5, a rating of corresponded to the least comfortable

and 5 to the most comfortable. The participants were also asked to judge

17

whether they were more of an auditory, visual, or hands-on learner. This
information was used during the data analysis to see if a bias existed in how
the participants performed relative to the testing condition in which they were
placed.

Recording of Data

It was necessary to document the participants’ verbal and nonverbal
responses to the experimental task for data analyses. Each participant had a
data record form with his identiﬁcation number on it (see Appendix L). This
form identiﬁed which experimental group the participant was in and whether he
was able to complete the nonverbal performance measure. The participants’
responses to the post-task survey also were recorded on the same form.

A cameraman was present to record all participants’ performances of
the verbal and non-verbal measures. This was done with a Sony digital
camera model number DCR-TRV140 NTSC. In addition, the procedural
discourse was audio taped with a Panasonic mini cassette recorder model
number RQ-L10.

Description of Performance Measures
Non-verbal Measure

The participants were judged by two different measures. The ﬁrst was
their ability to non-verbally re-produce the paper-folding task on their own.
This nonverbal portion of the task was assessed right after the task training
input in order to observe immediate recall. This same portion was also

assessed after a 20-minute delay in order to observe the participants' retention

N

of the task. The non-verbal performance was measured in terms of the
number of correct steps of the task that each participant was able to complete.
Verbal Measure

The second measure of the participants’ performance was their ability
to describe the procedure for doing the task. Again, the participants were
asked to discuss the procedures for completing the task immediately after task
training, and after a 20—minute delay.

The verbal performance, i.e., the procedural discourse, was evaluated
in terms of total number of correct information units (ClUs) given by each
participant (Nicholas & Brookshire, 1993 as cited in Hinckley, 1999) (See
Appendix M). The system of identifying ClUs is a “rule-based system for
quantifying the inforrnativeness of connected speech elicited with a variety of
stimuli” (Nicholas 8 Brookshire, 1993).

Scoring of Data

This investigator scored the nonverbal measure, or the number of
correct steps that the participants were able to perform. After this was done
someone else scored a portion of the nonverbal data for reliability purposes.

This investigator also orthographically transcribed all of the procedural
discourse provided by the participants. These transcripts were then
distributed to three certiﬁed speech-language pathologists for scoring the
verbal measure. These clinicians ﬁrst counted the total number of words

provided by each participant. Then they counted how many of these words

14

qualiﬁed as ClUs. I This was done according to the rules for scoring and
counting words and ClUs provided by Nicholas and Brookshire (1993).
Reliability of Judgments

As mentioned above, after the examiner scored the number of correct
steps that each participant was able to complete, another judge, a Michigan
State University engineering graduate, independently judged a portion of the
nonverbal data. A point-to-point comparison of the judgments yielded a 97%
agreement for the nonverbal task.

As mentioned above, the participants' verbal responses were randomly
assigned to three judges in equal number. Each judge received responses
from participants in each of the three experimental groups, but was blind to
which group each participant belonged.

To assess the reliability of these judgments, each judge, on a different
occasion, re-scored a portion of the data she had previously scored in order to
obtain a measure of self-agreement. A signiﬁcant difference between how the
judges scored the data from time 1 to time 2 was not found (t = 0.96, p > 0.05).

Inter-judge reliability was assessed to determine the extent with which
the judges agreed amongst themselves. To do this, each judge took a portion
of the data previously scored by each of the other two judges and re-scored it.
While there were some differences among judges noted, there was no

signiﬁcant difference found (t = 0.77, p > 0.05).

Statistical Analﬁis of Data
The student Minitab (Schaefer, R.L., & Anderson, RB, 1987) Software

was used for the statistical analysis of the data. This program provided
measures of central tendencies as well as Type One error probability.
Comparisons between the experimental groups were also made using a two-

sample t-test.

’26

Chapter Three

RESULTS

In this study, participants were taught a novel, procedural task under
one of three sensory input modality conditions. Participants received either
auditory input only, or they received both auditory-verbal and visual input, or
auditory-verbal plus visual and tactual input. After Ieaming the task, they had
to demonstrate their Ieaming by performing the task and by providing verbal
procedural discourse about the task. This demonstration of Ieaming took
place immediately following the task instructions and after a 20-minute time
delay

Quantitative Data Analﬁes

Given the exploratory nature of this study and the small number of
participants observed, statistical analyses of the data were guided by the use
of a liberal alpha level for rejecting the null hypothesis (p = .10 or less). This
less stringent approach allowed the investigator to maximally exploit the data
for trends that could be more rigorously tested in future research.

Verbal Performance

Table 2 on page 45 represents the between-group and within-group
differences in the participants’ verbal performances (i.e., the procedural
discourse provided by the participants) before and after a 20-minute time
delay. From the procedural discourse, the number of correct information units

(ClUs) was determined (see criteria in Appendix M). The number of CNS for

’27

each participant in each group was obtained. The 3 experimental groups were
compared on their mean number of ClUs using a between group one-way
analysis of variance. The 3 treatment groups means were statistically
compared using Tukey’s post-hoc statistic.

Each experimental group also was compared to itself. The mean
number of ClUs produced by a particular group before and after the 20-minute
time delay was calculated using a two-sample t statistic.

Table 2. Group Outcomes gn Verbal Performance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Time 1
Group 1 Group 2 Group 3
(Aud. Input) (Aud+ Vis Input) (Aud+Vis+Tact. Input)
N 7 7 7
Mean ClUs 72.0 92.1 89.4
SD 32.3 47.3 41.1
E value E
(df=2,18)=
0.50, p >
0.10
Time 2
Mean ClUs 81.4 81.4 122.7
SD 33.9 42.6 23.1
t_ score 053, p = 0.61 I0.44, p = 0.67 -1.86, p < 0.095
13 value E
(df=2,18)=
3.40, p <
0.056

 

38

 

Between Groups

Iim_e_1. As Table 1 shows at time 1, group 2, which received auditory
and visual sensory input, produced the highest mean number of ClUs (M =
92.1, S_D = 47.3). Group 3 which received auditory, visual and tactual input
had the next highest mean number of ClUs (M = 89.4, S_D = 41.1) and group
1, which received only auditory sensory input, produced the lowest mean
number of ClUs (M = 72.0, SQ = 32.3). However, a one-way analysis of
variance (ANOVA) revealed no signiﬁcant group main effect (F (df=2,18) =
0.91 p > 0.05) before the 20-minute time delay.

M. Comparison of the mean number of ClUs produced by each
group after the 20-minute time delay, revealed no signiﬁcant difference
between the group that received only auditory sensory input (M = 81.4, SQ =
33.9) and the group that received auditory and visual sensory input (M = 81.4,
SD = 33.9). However, the group that received tactual sensory input in
addition to the auditory and visual sensory input produced a signiﬁcantly larger
mean number of ClUs (M = 122.7, S_D = 23.1) than did either of the other
groups. The one-way ANOVA revealed a signiﬁcant group main effect (F
(df=2,18) = 3.40 p < 0.05). Pair wise group comparisons of the experimental
groups” CIU means using the Tukey statistic (g = 5.09) revealed that the group
that received the tactual sensory input was signiﬁcantly higher than the group
that received only the auditory sensory input and the group that received the
auditory and the visual sensory input; the latter two groups did not differ

signiﬁcantly from each other.

39

Within Groups

In addition to examining between group differences, each group was
compared to itself before and after the 20-minute time delay for displaying
what had been Ieamed (see Table 1). The t-test analysis revealed no
statistically signiﬁcant difference before or after the time delay for any two
individual groups compared. However, by using the liberal alpha level of .10, it
can be seen that the tactual input group differed signiﬁcantly from the other
groups in the mean number of ClUs produced. This was the only group to
show any measurable change from time 1 to time 2 (t = -1.86, p < 0.095). This
outcome suggests that when given an opportunity to consolidate the sensory
input over a period of time, even a brief amount such as 20-minutes,
performance is enhanced by the additional sensory input offered by the tactual
modality.

Nonverbal Performance

This analysis focused on the outcomes when the participants attempted
to do the nonverbal or the origami task independently of any input from the
investigator. Just 1 (14%) of the 7 participants in the auditory-verbal group
completed the nonverbal origami task. In the auditory-visual group, 4 (57%) of
the 7 participants did so, as did 5 or 71% if the 7 participants in the auditory-
visuaI-tactual group. However, the main analysis focused on the number of

steps performed correctly irrespective of task completion.

40

 

Table 3 shows the between group and within group differences for the
participants’ nonverbal performances both before and after the 20-minute time
delay.

Table 3. Group Outcomes on Nonverbal Performance

 

 

 

 

 

 

 

 

 

 

 

 

 

Time 1
Group 1 Group 2 Group 3
(Aud. Input) (Aud.+Vis. Input) (Aud.+Vis.+Tact. Input)
N 7 7 7
Mean # of 4.8 13.8 14.0
Correct Steps
SD 5.4 5.2 4.2
E (df=2,18)=7.65, p <
0.004
Time 2
Mean # of 4.8 12.4 14.1
Correct Steps
SD 5.4 5.8 3.5
t score I0.00, p = 1.0 0.48, p = 0.64 -0.0, p= 0.95

 

 

 

E (dﬁ2,18)=6.70, p_ <
0.007

 

 

 

Between Group Effects

As shown in table 3, the group that received just auditory sensory input
performed the least number of correct steps to complete the nonverbal task (M
= 4.8, _S_D_ = 5.4). The average number of steps completed by the group that
received auditory and visual input and the group that received auditory, visual
and tactual sensory input varied from M_= 13.8, S_D= 5.24 to M= 14.0, S_D=

4.2 respectively. The group that received the combined auditory, visual and

41

tactual sensory input completed the most steps on the average. The F test of
differences among group means revealed a signiﬁcant between groups effect
(E = 7.6 (df = 2,18), p < 0.004) in the mean number of correct steps performed
before the 20-minute time delay.

Pair wise comparison of group means using the Tukey statistic (g =
11.3, p < .05 for the smallest difference between two means) revealed that this
main effect was due to the difference between the group that received only the
auditory sensory input and each of the other groups. There was no difference
between the group that received auditory and visual sensory input and the
group that received all 3 sources of input.

The results were similar when the groups were compared after the 20-
minute time delay. Again, the group that received only the auditory sensory
input performed the fewest number of correct steps (M = 4.8, S_D = 5.4). After
the delay, there was a slightly larger difference between the numbers of
correct steps performed by the group that received auditory and visual sensory
input (M = 12.4, S_D = 5.8) and the group that received auditory, visual and
tactual sensory input (M = 14.1, S_D = 3.5). The F statistic revealed signiﬁcant
group differences (E = 6.7 (df = 2,18), p < 0.007) in the mean number of
correct steps performed after the 20-minute time delay. Using the Tukey
statistic to test differences among group means (g = 11.3, p < .05 for the
smallest differences between means), it was shown that the signiﬁcant main
effect was due to the auditory only group having signiﬁcantly lower scores than

the other two groups.

42

Within Group Effects

As was done with the verbal measure, the t-statistic was computed to
compare the same group’s non-verbal replication of the task at Times 1 and 2.
As shown in Table 3 none of the groups showed a signiﬁcant difference in the
number of correct steps performed before and after the 20-minute delay. The
t scores for the auditory-verbal, auditory-visual, and auditory-visual-tactual
groups were respectively 0.61, 0.67, 0.09 and all were non-signiﬁcant even
when a liberal alpha level (p > 0.10) was used.

9W

Qualitative data were obtained after the completion of both the verbal
and non-verbal measures. The participants were asked if there was anything
that would have made the task easier to perform. This question was asked in
order to gain more insight into how the different sensory channels may have
affected the participants’ performances. The outcomes were also expected to
help the investigator understand whether any procedural changes could be
made to improve the experiment in future studies.

When the participants were asked if there was anything that would have
made the task easier, the responses varied. Table 4 illustrates the variety of

responses obtained from each group.

43

Table 4. Participants’ verbatim responses for making the task easier

 

Group 1
Auditory Input

Group 2 Auditory and Visual
Input

Group 3 Auditory, Visual and
Tactual anut

 

”having [heard the directions]
three times complete instead
of hearing the directions three
times individually"

"knowing that the tape would
not have accompanied my
own attempt” *

"nothing would have made it
easier” **

 

“if it had a name indicating the
end result"

"not going into another room
for a distraction”

"told in advance I'd be doing
the task"

 

”being able to see someone
do it, or if I had the paper in
my hand doing it while I
listened"

”being able to show how to
explain instead of having to
tell how to do the task"

”being told how to do it a
couple more times”

 

”hearing the instructions a
third time”

"maybe seeing it again"

"going over the instructions
again after the 20 mintue
delay”

 

”having more clear
instructions"

"being able to listen to the
instructions with the paper in
hand"

"if it wasn't so quiet in here”

 

”slowing down the last section,
or hearing it while I did it"

 

 

"nothing would have made the
task easier”

 

 

Note. * Indicates that one other participant gave this response
Note. ** Indicates that more than one participant gave this response.

Participants in the group that received only auditory sensory input

tended to give responses that were directed towards the quality of the

directions themselves.

In only one instance did a participant answer this

question by saying that it would have been helpful to receive the instructions

(i.e., sensory input) in a different sensory modality than the auditory one.

Participants in the group that received auditory and visual sensory input

had a variety of responses. However, 2 of the 7 participants stated that the

task would have been easier had they been given tactual input.

 

The group that received the auditory, visual and tactual sensory input
had the most participants say that nothing would have made the task easier.
Two of the 7 participants, however, commented that receiving the instructions
a few more times would have been helpful to their performances.

In addition to asking the participants if there was anything that would
have made the task easier, they were also asked to rate their comfort level,
i.e. their level of conﬁdence that the task was done correctly. The scale of 1 to
5 was used; 1 represented least comfortable and 5 the most comfortable. For
the group that received auditory sensory input, the rating averaged 2.0. The
rating averaged 3.0 for the groups that received auditory-visual sensory input
or auditory-visual-tactual sensory input. This latter outcome indicated that the
visual and tactual groups felt slightly more conﬁdent that the task was done
correctly.

Finally, each participant was asked whether he judged himself to be an
auditory Ieamer or a visual or hands-on Ieamer. The investigator wanted to
see if there were any relationships between these reported self-biases in
Ieaming and the participants’ actual performances. Table 5 summarizes these

results.

45

Table 5. Participants’ remrts of personal Ieaming gpe

Judged Learner
Type

Experimental Group

Aud-Vis Aud-Ws-Tac
0 1

Visual 4 4

 

Hands-On 3 2

Regardless of group assignment, at least half of the participants in each
experimental group judged themselves to be visual Ieamers. Across the 3
groups, 13 or 62% of the participants judged themselves as visual Ieamers,
whereas 6 or 28% reported themselves to be tactual or hands-on Ieamers.
The participants were least inclined to judge themselves as auditory Ieamers
(N = 2 or 10%). Therefore it was not surprising that there did not appear to be
a direct relationship between the type of Ieamer each participant felt he was
and his actual performance in an assigned modality condition.

The one participant in the auditory only group who reported himself to
be an auditory Ieamer was not able to replicate the nonverbal task. He also
was 1 of 6 participants who failed to do so. Just 1 participant in this auditory-
verbal group correctly completed the task. He reported himself to be a visual
Ieamer.

Of the 4 participants in the auditory and visual input group who judged
themselves to be visual Ieamers, only one was able to correctly complete the
nonverbal task. The other 3 participants in this group reported themselves to

be hands-on Ieamers. All of them were able to complete the task.

46

In the auditory-visual-tactual group the two participants who reported
themselves as hands-on Ieamers were both able to correctly complete the
nonverbal task.

It is interesting that 5 or 50% of the participants who did the task
correctly reported themselves to be hands-on or tactual Ieamers. The task
also was completed by the same number of persons who reported themselves
to be visual Ieamers.

Conclusion

When Ieaming a new procedural task, the sensory input does matter to
both the verbal and nonverbal performance as was measured in this study.
The results consistently showed that the participants were at a disadvantage
for Ieaming a new procedural task when they received just auditory-verbal
input, as pilot data had predicted. However, the results did not show uniformly
better performance when participants received tactual input in addition to
visual input as expected. The group that got the added visual input was just
as successful as the added tactual group on some tasks. Since performance
seemed enhanced when visual or tactual input was added, it can be assumed
then that Ieaming a new procedural task is optimized when other sensory

inputs are provided in addition to auditory-verbal input.

47

Chapter Four

DISCUSSION

The goal of this study was to determine whether performance on a
novel task is affected by the sensory modality in which participants receive the
instructions for doing an origami task. The participants were 21 male college
students. They were randomly assigned to one of three groups that differed in
the sensory input condition for receiving task instructions. One group was
given the instructions with just auditory verbal input. A second group received
visual input in addition to the auditory input. The third group received tactual
and visual input in addition to auditory verbal input. Aftenrvards, the
participants attempted to do the task and provide a verbal description of how
to do the task. The participants’ nonverbal performances were analyzed for
the number of correct steps performed before and after the 20-minute time
period. Their verbal performances were analyzed for the number of correct
information units (ClUs) provided about the task and their nonverbal
performances were evaluated in terms of the number of steps performed
correctly regardless of whether the origami task was completed.

The ﬁndings revealed a differential modality effect on the participants’
performances. The data supported some expectations but not others. The
experimental group that received just auditory verbal input performed the least
well on both the nonverbal and verbal performance measures, as expected.

This observation suggests that auditory verbal input alone offered the least

information about how to do the kind of novel procedural task used in this
study. Performances were signiﬁcantly better in the groups that received the
additional visual or visual and tactile input.

However, the expectation that the tactual group would perform better
than both the auditory and the auditory-visual groups was only partially
supported by the data. The tactual group performed remarkably better on the
verbal task but not on the nonverbal task. Even on the verbal task, the tactual
group performed better than the other groups only on the second trial, i.e.,
after the 20-minute interval. The failure to observe consistent signiﬁcant
differences between the groups that received the added visual input and the
added visual and tactual inputs was surprising, particularly for the nonverbal
task. This outcome for the nonverbal task as well as the outcome of the verbal
task may have resulted from some methodological limitations of the study as
will be discussed later in this chapter.

In sum, the ﬁndings were not straightforward. Performances were
inﬂuenced in a complex way by the (1) presentation modality, i.e., auditory-
verbal versus auditory-verbal and visual, versus auditory-verbal, visual and
tactile, (2) the timing of performance, i.e., before and after a 20-minute delay
for displaying Ieaming (3) the type of performance domain assessed, i.e.,
verbal versus nonverbal. The following discussion focuses ﬁrst on interpreting
the modality group differences in verbal and nonverbal performances as a
function of the memory task. Second, the implications of this study for future

research are discussed. The methodological limitations of the current study

49

are discussed within the context of doing future research. Finally some clinical
implications of the ﬁndings from this study and similar future studies are
identiﬁed.

Integpretation of Verbal Effects

This study was guided by the assumption that the different sensory
modalities provide different information about verbal events, and these
inherent differences may partly explain the outcomes of this study.

The Auditogy-Verbal Modality Effect

The most consistent outcome of this study was that auditory-verbal
input alone was not sufﬁcient to Ieam the novel procedural task well enough to
actually do it or talk about how to do it. One reason for this outcome has to do
with the serial processing demands of Ieaming an auditory task, as presented
in this task. The other reason has to do with the natural limitation of auditory-
verbal input alone for initially deriving the semantic content of words from a
real event.

Serial complexﬂy of the auditogy-verbal task. By all accounts the
auditory verbal task used in this study was very complex. This is because the
verbal directions required the sequential processing, memory, and retrieval of
so much verbal information in order to understand how to do and talk about
the task aftenrvards. For the origami task used, the participants had to hold as
many as 17 verbally delivered chunks or sentences in memory before they
could Ieam the task well enough to talk about how to do it. Furthermore, the

novelty of the task prevented participants from relying too heavily on their

50

previously stored semantic content for the words spoken in the instructions.
They were not even given any information about what the ﬁnal product or task
goal was suppose to look or feel like. Given the rapid decay time of auditory
input relative to other sensory modalities, the reduced performances observed
were not surprising.

In contrast to the rapid auditory input with quick decay time the visual
modality presents fewer and slower spatio-temporal changes in the perceptual
ﬁeld. The tactual input also involves temporal demands, but its combined
serial and spatial properties seem less susceptible to the rapid temporal
changes and stimulus decay associated with the auditory modality (Heller 8r
Schiff, 1991; Strei 8r Pecheux, 1986). The participants also have more control
over how fast or slow to move in getting the tactual input. It is not surprising,
therefore, that when questioned about what would have made the task easier,
participants in the auditory verbal group more often focused on ways to slow
down the input or enhance it in order to decrease the information procession
load for getting content into memory. In contrast, just one participant in each
of the other experimental groups commented on the need to experience the
input more often in order to Ieam it.

Role of auditory inp_ut in determining the semantic content pf wp_r_d_s_.
Another reason why the auditory—verbal group may have been the least
successful in their verbal descriptions of the origami task used in this study is
that auditory-verbal input may play a less salient role in getting the Initial

semantic content of words from the event context than do other modalities.

51

The auditory word forms are just symbols - they index or represent the
objects, actions, relationships, or states that words refer to in the real world;
they are not synonymous with them in real world experience. So just hearing
the words alone provides no information about what these objects, actions, or
states actually are in a real world sense, if they have not already been
experienced. In this study, the participants in the auditory-verbal condition
received no contextual or event information about the origami task. For
example, they did not have direct access to the shape, form, or
transformations of object relationships involved in creating the origami product.
This view suggests that the auditory-verbal modality is particularly suited to
Ieaming the form of the linguistic or verbal input, i.e., the arrangement of
phonetic/phonological symbols that conform to the morphosyntactic patterns
or rules of a language. But these forms alone do not provide direct input about
the meaning or semantic content of the forms in the actual situation. To get the
meaning or semantic content of spoken forms, speakers/listeners must relate
these heard forms to some events in the real situation or to already stored
experiences about linguistic meaning or content. If the retrieval of this stored
content is inefﬁcient, as can be the case with traumatic brain injuries, the
reception of new content will be hindered. Simply put, a speaker/listener may
not comprehend what is being said. Therefore, it is not surprising that the
auditory - verbal group performed the least well on both performance
measures used in this study. Unless the participants had previous experience

with origami tasks, they would be expected to have a difﬁcult time attaching

52

meaning to the spoken words, then it would have been extremely difﬁcult to
Ieam how to do the origami task or tell someone else how to do it.
Tactual versus Visual Modality Effect

As mentioned above, the experimental groups that received task
instructions with some visual or some visual and tactual input performed much
better than did the auditory-verbal group. When visual or visual and tactual
inputs are received along with auditory verbal input, then information is offered
in the perceptual stream about the possible semantic content of the
auditory/verbal forms used. For example, both visual and tactual inputs
provided direct experience with the spatial and temporal aspects of the events
involved in doing the origami task. Participants could see the shape and color
of the objects used in the event along with the actions used to create the
changes that occurred with each folding act. All the same information was
available to the participants who got the tactual input. But in addition, they
could feel the stimuli and what their bodies had to do to create the actions that
resulted in the various steps of doing the origami task. So they could directly
experience the cause/effect relationships involved in the act of creating the
product from doing the origami task. It should not be surprising then that
participants in the experimental groups that got the additional visual or visual
and tactual inputs were able to provide more CIU units in the verbal task than
were those in the auditory-verbal group. The CIU units were based on

semantic content.

However, the prediction that the group with added tactual and visual
input would do better than the group with just added visual input was not
conﬁrmed for both verbal tasks. It has been reasoned that receiving 3 sources
of input about an event as in the case of the tactual group would provide more
information for Ieaming the origami task than two sources as in the case of the
visual group. While the differences between these two groups were not
signiﬁcant before the 20-minute break, they were signiﬁcant in the expected
direction after the 20-minute waiting period. The participants who got the
added tactual experience performed better than those who got just the added
visual experience for doing the origami task. This outcome, though not
expected, was similar to the results reported by Stockman and Latham (2001)
for typically developing preschoolers who participated in a novel juice making
task.

The results of the present study are important because they showed a
trend toward a tactual input bias even for mature, normally functioning adults.
This observation, though preliminary, is important. This is because of the
prevailing tendency to view the “hands-on” Ieaming as essentially relevant to
young child Ieamers and not to mature Ieamers. This study suggests,
however, that the tactual input may enhance adult Ieaming of novel procedural
tasks. This was the case despite the assumption that the college males used
in this study had abundant auditory and visual processing experiences from

attending class lectures.

54

The connectionist model proposed by Rumelhart and McClelland
(1986) supports why this kind of result was seen. The main idea of this model
is that information is stored in multiple locations throughout the brain. These
locations form a network of connections. The more connections one has to
new information, the more likely it is to be remembered. By providing the
participants with the tactual input, they were provided with additional
connections to the new information that the participants in the other
experimental groups did not receive. Therefore, it can be assumed that based
upon the connectionist model, the participants that received tactual input
would have a greater chance of remembering the newly Ieamed information.

A modality bias favoring the tactual modality may not have been seen
until after the 20-minute time period because of the complexity of the task. The
participants had to process information from multiple sensory modalities.
Moreover, they had to do so quickly and in a serial manner. This is because
the sensory inputs were not simultaneously presented. They ﬁrst heard the
verbal instruction. Then they had to watch the examiner to at least begin an
action step before trying to do the same step on their own. This meant that
instead of receiving all of the sensory input at once, the participants had to
coordinate the inputs one at a time as they received them. They had to
quickly switch back and forth between watching the examiner doing the task
and then actually doing the task themselves. This forced the participants to
remember what they had just previously heard, saw or done. Remembering

these temporal events could have increased memory load and strained

performances in similar ways to the processing of auditory input. This
integration of multiple input sources may have in fact impeded participants’
performances instead of enhancing them at ﬁrst.

The results of this study with adults are consistent with the observations
that children’s performances can be degraded when multimodal information
must be processed. For example, Stockman and Latham (2001) reported that
preschoolers who received tactual input during a novel juice making task had
signiﬁcantly better verbal performances than did those who received visual
and auditory input from a video of the juice making event. However, the tactual
group performed better only on their second trial - not the ﬁrst one.

Gazella (1997) and Gazella and Stockman (2003) suggest that even
the combined auditory and visual input in a story presentation and retelling
task may tax processing resources more than when a story is presented in just
the auditory-verbal modality. Gillam, Cowan and Marler (1998) reported that
children with speciﬁc language impairment have more difﬁculty using
phonological features of auditory verbal codes during tasks requiring “ multiple
mental operations” such as speaking and pointing at the same time.

Bloom (1996) proposed the cognitive cost hypothesis to account for
the observed decrease in verbal performance when children engage in doing
more than one thing at the same time. In one study, Bloom and her colleagues
observed whether children expressed emotion and talk at the same time.
They looked at children whose ﬁrst words were emerging and children who

were going through the vocabulary spurt. Children who were just beginning to

56

talk either talked or expressed emotion, but they did not do both at the same
time. At older ages, children were able to talk and express emotion at the
same time. Yet the words used tended to be both familiar and routine. Bloom
and her colleagues (1996) also observed how children talked during play. She
found that when the children played with unfamiliar toys, their talk was limited.
These children also demonstrated limited emotional affect when playing with
unfamiliar toys.

Tomasello and Kruger (1995) did a study in which 2;0 year old children
were taught a new word before, during, or after an event. They found that
children were less likely to Ieam a novel word when it was presented at the
same time as the event. This outcome was interpreted in terms of processing
constraints. Tomasello and Kruger suggested that hearing the new word
during the event required the children to process double the information (i.e.,
information about the word and about the event). This increased the task
demands for these children.

In the present study, however, the initial linkages between auditory-
verbal forms and their visual semantic content were apparently not strong
enough to show Ieaming in both verbal trials. Othenrvise, this same group
would have improved their verbal performances in the second trial just like
those in the tactual group. But since this did not happen, one can infer that the
added visual support was less effective than added visual and tactual support

for Ieaming the task used in this study. This temporal effect on displaying a

57

modality difference is a very interesting and unexpected ﬁnding from this

study. Obviously more research is needed as discussed next.

lntegpretatlon of Nonverbal Effects
Auditogy Verbal Modality Effects

The nonverbal performances of the individuals who just received the
auditory-verbal input were not at all surprising. It was expected that of the
three experimental groups, these individuals would perform the least number
of correct steps to complete the task, given the pilot study results. It was not
expected that the words heard by participants would be enough to Ieam to do
the task unless there was already some prior experience with origami as
discussed already. The results supported that expectation. In fact, during the
Ieaming phase of the experiment, some individuals in the auditory only group
appeared restless in their seats or sighed loudly - behaviors that can be
interpreted as a sign of feeling overwhelmed. All but one participant in this
group gave up when trying to do the task nonverbally. This outcome suggests
that the auditory-verbal input alone offers limited beneﬁt for Ieaming a novel
procedural task well enough to perform it or talk about it.

Nonetheless, the fact that one participant was able to complete the task
shows that it was not an impossible task to Ieam. However it is Interesting
that this participant pantomimed the steps as he heard them presented
auditorally. That is, he was seen working through the steps with his hands
without the paper while listening to the instructions. Such an observation

supports the importance of getting input from more than the auditory modality

58

Visual and Tactual Modality Effects

What proved to be a surprising result is that there appeared to be no
performance advantage for the experimental group that received the additional
tactual and visual input over the group that received just the additional visual
input. Just one more participant (5 or 71%) in the group with tactual input
performed the nonverbal task compared to the 4 or 57% in the group that
received just the added visual input. Furthermore, there were no signiﬁcant
differences between the visual and tactual group in the number of steps
completed for doing the task on neither the ﬁrst nor the second trial.

The absence of a modality difference here suggests that the added
tactual input was less vital to Ieaming how to perform the novel procedural
task nonverbally for these adult Ieamers than it was for the verbal task. In
fact, the number of steps completed for the nonverbal task hardly shifted from
time 1 (before the 20-minute time interval) to time 2 (after the 20-minute time
interval) for either group. No more than half of the participants actually did the
nonverbal task. 80 many participants were not able to do the task regardless
of whether they received instructions in one or more modalities. It is predicted
that participants needed to have more input trials than were given in this study.
This is not surprising. Learning what to do would have required a high level of
cross-modal integration by both groups, i.e., auditory and visual integration in
one group and auditory, visual and tactual integration in the other group. The

research on children, as described above, suggest that there are performance

<(

research on children, as described above, suggest that there are performance
costs when Ieamers have to process more than one source of information at
the same time.

However, the information processing demands must not have been the
same for the verbal and nonverbal tasks used in this study. Although, the
tactual group did not increase its verbal performance in the ﬁrst trial, its verbal
performance improved signiﬁcantly in the second trial. The same second trial
effect was not observed for their nonverbal performances.

The differences between the verbal and nonverbal performances of the
tactual group may be related to biases in the way the experiment was setup in
addition to any factors related to processing demands on performance. On
both the ﬁrst and second trials, the participants in this study always performed
the nonverbal task before the verbal task. Therefore the verbal performances
could always have been aided by the prior nonverbal performances, but
nonverbal performances could never proﬁt from having verbally described the
steps for doing the task before hand. Failure to randomly test verbal and
nonverbal performances created a confound in the data. So it is unknown how
much of the verbal advantage observed for the tactual group on trial 2 was
due to the consolidation of memory for the task during the 20-minute time gap
or to access to prior experience with doing the task (or at least attempting to
do the task) before a verbal description was given. Nevertheless, the question
remains as to why performance was not elevated in the ﬁrst or second trials

for the participants in the other two experimental groups, namely those in the

60

auditory-verbal group and those in the auditory-verbal and visual groups. Their
verbal descriptions also had the opportunity to beneﬁt from these participants’
prior attempts to do the action. Yet their verbal descriptions did not improve on
Trial 2 like those in the tactual group. Cleariy more research is needed, as
discussed next.
Implications for Further Research

This study provides interesting information to support the claim that
tactual sensory input is important even when adults are Ieaming new
procedural tasks. But further research in this area is necessary to gain a
better understanding of the tactual modality’s role in Ieaming such tasks.
Although motivated by the clinical intervention needs of persons with traumatic
brain injury, this study did not focus on a clinical population. So research
obviously is needed about whether the performance trends of this study apply
to a clinical population with TBI. At the same time, research needs to continue
focusing on the varying roles that different sensory systems may play in
Ieaming different types of tasks even among normal Ieamers. Several data
trends in this study supported the expectation that the tactual input is helpful to
Ieaming how to do a procedural task even for smart normal adult Ieamers, but
more rigorous research on larger numbers of participants is needed to defend
any claims about the role of the tactual input in Ieaming novel procedural
tasks. The following discussion singles out several factors that may have

contributed to the failure to reveal a stronger effect in this study. They relate to

61

methodological and research design limitations that should be taken into
account in designing future studies.
Methodolpglcal Limitations In the Present Study

There are several reasons why the results of this study may not have
conﬁrmed the predictions or expectations for the nonverbal task.

Order of scoring the time 1 and time 2 data. First, there may have been a
methodological ﬂaw in how the judges scored the verbal data. All
performances before the time delay were scored before the performances
after the time delay. Failure to randomize the order in which the two trials were
judged may have confounded the outcomes. The tactual group may have
performed better in the second trial than the ﬁrst trial because the judges had
become more familiar with the scoring procedures by the second trial. But this
interpretation must be tempered by the fact that the performances for the other
groups did not increase signiﬁcantly from time 1 to time 2. Still a post-hoc
analysis was done to determine whether such a confounding practice effect
might have occurred. This could be done because the judges had scored just
a third of the data for the reliability analysis, which was described in Chapter 2.
Altogether, each judge scored the performances of 4 new participants such
that Trial 1 performances were scored ﬁrst for two participants while Trial 2
performances were scored ﬁrst for others in a random assignment. The 12
new scores were calculated and pooled across the examiners and added to
the previously scored data for a new statistical analysis. The F test revealed

no signiﬁcant differences among the 3 experimental groups’ verbal

62

performances before the time delay (E (2,18) = 0.46 , p = 0.64). This outcome
was consistent with those already described in the results chapter. Results of
the F test after the time delay also revealed no signiﬁcant trend (E (2.18) =
2.12 , p = .15). This latter outcome contrasts with the signiﬁcant group
differences already described in chapter 3, which showed a signiﬁcant tactual
effect. Although this post-hoc analysis revealed no signiﬁcant difference, the
tactual group still had a larger mean number of verbal ClUs than did the other
groups. The means and standard deviations were 118.3 (_S_Q = 19.06), 87.4
($541.4) and 80.6 (E =43.7) for the tactual, auditory-verbal and visual
groups, respectively. A series of two sample t tests revealed that only the
difference between the tactual and visual groups in the post hoc analysis ( = -
2.09, p < .07) reﬂected a signiﬁcant trend. But no signiﬁcant differences were
observed between the auditory-verbal and the tactual group ( t = 1.79, p =11)
nor between the auditory-verbal and the visual group ( t= .43, p = .77). So
apparently, the tactual group still retained an edge in its performances over the
other groups after the time delay even in this post hoc comparison with
randomized data sets. But this potential effect needs to be tested more
rigorously in future research.

When taken together, the results of this study suggest that the order in
which the data before and after the time delay were scored may have affected
the results. Another study in which the verbal performances are randomized
during scoring is necessary to determine if the results would differ from those

obtained in this study.

63

Number of participants. The expected results might not have been
obtained simply because too few participants were included in the study. Just
7 participants were included in each experimental setting. The 21 participants
is a fairly small number, making it difﬁcult to get a real We picture of central
tendencies. Future research studies should include a greater number of
participants.

Tyg of pppulation. A third reason why a stronger expected effect was
not observed may have been due to the population studied. This study used
young college age adults with normal developmental histories. As college
students, these participants are likely to have very high levels of experience
with processing auditory-verbal and visual information, just to get lecture
content in college classes. So the differential effects of sensory input may be
less obvious for a novel task than they might be in other populations with less
of this kind of experience.

Besides studying adult clinical populations with impaired brain
function like TBI, research should include young typically and atypically
developing children as well. Future studies can be designed to test whether a
tactual input bias is more salient for younger than older Ieamers.

Providing the tactual input in the Ieaming condition. The way in which
the task was done could be another reason why the expected results were not
obtained. It should be noted that a valid clinical application of guided
interaction clinical practices was not done in this study. A valid application of

guided interaction requires the clinician to guide the patients hands and body

64

to do a task so that tactual input from causal actions are experienced
simultaneously with their auditory and visual effects as in real life events.
However this investigator had not been trained to do guided interaction
intervention. So it was not done in this study. But future studies can be done to
determine if the manner of delivering the tactual input is indeed a variable in
Ieaming a new task.

Perhaps the expected verbal results were seen only after the time delay
because participants needed the extra time to consolidate so much new
information, given the complexity of the task. Because this task had a serial
component it is reasonable to assume that this information took longer for the
participants to process. A more accurate representation of the effects of
tactual sensory input may have been seen had the participants received the
tactual input through guided interaction. The guided interaction would have
decreased the complexity of the task by eliminating the serial nature of the
sensory input integration. By eliminating the serial nature of the task, there
would have been less stress on the participants’ memory.

Craik and Lockhart (1972) proposed the levels-of-processing theory. It
might explain why the expected verbal results were seen after the time delay.
This theory of information processing claims that when Ieaming a new task,
we use different levels of elaboration as information is received. People
process information ﬁrst by attending to or orienting to the stimuli. Then they
label the new information, and ﬁnally, they give meaning to the new

lnforrnation. The main point of this theory however, is that any of the stimuli

65

acted upon by sensory receptor cells will be permanently stored in memory.
But the level at which the information was processed will determine how the
information is retrieved from memory.

While the expected results were not seen for the nonverbal task in this
study, it does not mean that the same outcome would hold for other
populations.

Type of procedural task used. Clearly task complexity interacts with the
type of stimuli with which Ieamers interact. Thus a ﬁnal reason why the
expected results for the nonverbal performance measure were not observed
may have been because of the task itself. This study was a paper task. The
paper may not have been heavy enough to give the amount of tactual input
needed to provide adequate information. Also, this task had a lot of steps.
Perhaps a task with fewer steps may have elicited the expected results.
Theoretical Issues

There also are theoretical reasons to continue the investigative focus
on the roles of different sensory modalities in Ieaming, particularly as they may
relate to our understanding of how memory works. Given the bias in both
science and clinical practices toward Ieaming and remembering auditory and
visual stimuli, it is not surprising that less is known about the tactual system by
comparison. On the other hand, the role that auditory memory deﬁcits seem to
play in the Ieaming of language among children with speciﬁc language
impairment now is well documented (see for example, Gillam, Cowan, 8r

Marler, 1998; Marler, Champlin, & Gillam, 2001) among others.

66

However, the present study hinted that the memory processes
associated with tactual Ieaming may differ from those involved in auditory
verbal and visual Ieaming, and that multimodal Ieaming may pose different
processing demands on Ieaming and remembering than does the Ieaming
from a single modality. Intuitively, the organization of tactual sources of input
seems to be at the core of procedural Ieaming and memory. This is because
procedural Ieaming involves action sequences. The data trends in this study
point to the possibility that tactual memory processes differ from the more
frequently studied auditory-verbal memory processes. But we are likely to
know less about this kind of Ieaming and memory compared to auditory verbal
per se. Glenberg (1997) is among those who make the case for
conceptualizing memory systems in terms of action patterns. He reported that
memory for actions (performing a command such as “open the book”) is better
than memory for the verbal descriptions of the commands.” (Glenberg, 1997,
p.5). Future research can determine to what extent this kind of ﬁnding holds
for different test conditions and populations of Ieamers.

Clinical Implications
This study was motivated by the goal of ﬁnding out about how the
delivery of clinical services to individuals with a TBI may possibly be improved.
The focus on the varying effects of different sensory input modalities on
Ieaming a procedural task were studied because of biases in the way speech
and language therapy is conducted. Typically treatment sessions apply

auditory and/or visual inputs to Ieaming a new skill. Less often, do we see

67

auditory and/or visual inputs to Ieaming a new skill. Less often, do we see
tactual input used in a clinical setting. Yet the strongest and most consistent
result of this study was that auditory verbal input alone resulted in the poorest
performance for both the verbal semantic and nonverbal performances.

The results of this study coupled with further research may show some
beneﬁt to incorporating tactual input into treatment sessions at least for some
types of tasks. This study used a procedural task, which is very much like the
way in which individuals Ieam new tasks in their natural settings. Therefore, it
should be considered that when working with clients in a therapeutic setting
other sensory systems might be of beneﬁt, auditory-verbal and visual input
sources may not be the only helpful sources of input for stimulating the
Ieaming of new tasks. Severe patients, in particular, often need additional
support. Tactual input may provide the necessary foundation from which these
individuals can begin to re-establish their damaged skills.

If future research bears out the assumption that tactual input enhances
Ieaming, then the way treatment is done routinely would have to change.
There should be less emphasis on the paper/pencil type tests especially for
severe patients than on functional tasks that are likely to combine sensory
inputs in ways that include the tactual sources of input associated with
action/interaction in the environment. Fortunately, there are signs that therapy
models are moving in the direction of creating more functional environments

for retooling and retraining persons with acquired brain damage including

652

TBI patients are now being placed in community-based intervention
programs (M. Sadasivan, personal communication, April 18, 2003). This type
of treatment requires the individual to perform functional tasks in an actual
real-world situation. Treatment tasks are not artiﬁcial in nature. At the same
time the patient is provided with multi-modal input that includes the tactual
modality. As suggested by this study, multi-modal input may provide the
necessary input to establish memories for new Ieaming, and access to those
skills already Ieamed or affected by the injury.

This kind of trend in service delivery is supported by the trends of this
study. They suggest that multimodal sources of input are likely to be helpful to
reestablishing the linkages between auditory verbal forms and their semantic
content. The tactual input may turn out to be especially critical to give in the
multimodal stream of input for severe patients. If this type of beneﬁt can be
seen with normal adults, whose previous experiences have not been
disrupted or clinically challenged, then it is likely that the same type of beneﬁt
will be observed for individuals whose ability to connect stored experience with
auditory verbal forms in actual situations has become impaired. In fact, the
beneﬁt might possibly be even greater for TBI individuals as was the case in
the Latham and Stockman (2001) study of children with special needs. They
reported that when Ieaming a novel procedural task, children with language
Ieaming difﬁculties showed even more dramatic changes in verbal
performances than did typically developing children when tactual input was

given as opposed to just visual and auditory input.

69

This study suggests that tactual sensory information may play an
important role in Ieaming procedural tasks even for adult Ieamers without
cognitive disability. Other studies too, such as Stockman and Latham's (2001)
work with normal developing preschoolers support the importance of tactual
sensory input in Ieaming new tasks whereas the present study suggests that
tactual input may play an important role in normal adult Ieaming of novel
procedural tasks. As more supporting empirical support for this effect
become available, the orientation to speech and language therapy will need to
be modiﬁed. Clinicians will need to consider the “doing” of a task as sensory
input instead of the conventional thinking of the “doing” as only performance
output.

Conclusion

In conclusion, the results of this study suggest that tactual sensory input
may well provide valuable information for normal adults Ieaming a novel
procedural task under some conditions. This study suggests that receiving
auditory-verbal input alone is not sufﬁcient for Ieaming a novel procedural
task. Further research needs to be conducted to determine how these results
generalize to different populations and tasks. But information from this study
potentially can stimulate more research and theorizing about the role of tactile
input in the delivery of clinical services to both children and adults with

linguistic and cognitive impairments.

7O

APPENDICES

71

APPENDIX A

Participant Characteristics

Table 1. Participant Characteristics

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Participant # Major Age
1 engineering 18
2 hospitality business 18
3 advertising 20
4 telecommunications 21
5 hospitality business 20
6 turf grass management 20
7 communications 21
8 advertising 20
9 journalism 18

10 communications 21
11 hospitality business 20
12 hospitality business 20
13 general management 19
14 undeclared 18
1 5 psychology 21
16 communications 21
17 building construction 20

 

management

 

 

72

 

 

 

 

 

18 ﬁnance 1 9
19 pre-medical 19
20 international relations 18
21 undeclared 19

 

 

 

 

Mean Age = 19.5

 

73

 

APPENDIX B

Participant Recruitment Flier

Students are being sought to participate in a research study to be conducted

in the Communication Arts and Sciences Building.

Subjects must be:
1. Male
2. Caucasian
3. Between the ages of 18 and 21

All participants will be reimbursed for their time at a rate of $12.00/hour.

Janelle Rowe, a master’s student in speech-language pathology, is conducting
this study. This study will be looking at the area of new Ieaming. Dr. Ida
Stockman will be overseeing the study.

If you would like to participate in this study, please contact:
Janelle Rowe
rowejane@msu.edu
(989) 686-3165

V...

APPENDIX C

Participant Recruitment Flier for COM 100 Students

Folding for Dollars
Or Credit

Location: Room 14 Basement of COMM ARTS

. This study will be taking a closer look at how new Ieaming occurs.

Participants must be: male, Caucasian, between the ages of 18-21,
communication majors (preferred, but not required).

Name of Researcher: Janelle Rowe Researcher’s phone: (989) 686-
3165 Researcher’s email: rowejane@msu.edu

Number of Credit Hours (if chosen): 1.5

Monetary reimbursement (if chosen): $12

Appendix D

Participant Background lnfonnation

Background Information

Name: Age:
Sex: M F Student: Y N
Major: Race/Ethnicity:

1. Is your hearing within normal limits, or corrected to within normal limits?

2. Is your vision within normal limits, or corrected to within normal limits?

3. Do you have a history of brain injury?

4. Do you have a history of Ieaming disability?

5. Do you have experience with origami?

 

Subject Number:

 

OFFICE OF
RESEARCH
ETHICS AND
STANDARDS

University Committee on
lee-arch Involving
than Subjects
Michigli Slate University
202 Old: Hall

East Using, Ml

48824

517/356-2180

FAX: 517/432-4503

Web; mm Muse/wins
EM: ucrihsansucdu

Mammal: (ﬁrmly
omcwuramiowm-

Wow
twisanxﬁrrrm-xtm
Ind-W nstndm

APPENDIX E

Approval to Use Human Subjects

MICHIGAN STATE

 

UNIVERSITY

May 1, 2002

TO: Ida STOCKMAN
378 Com. Arts and Sciences

RE: IRE: 02.283 CATEGORY: EXPEDITED 2-4, 2-6
APPROVAL DATE: April 24, 2002

TITLE: SOLVING OF A NOVEL TASK UNDER DIFFERENT MODALITY INPUT
CONDITIONS '

The University Committee on Research Involving Human Subjects’ (UCRIHS) review of this

project is complete and I am pleased to advise that the rights and welfare of the human

subjects appear to be adequately protected and methods to obtain informed consent are

appropriate. Therefore. the UCRIHS approved this project.

Staff Note: The stamped consent has a small grammatical change in
section 7b. Be sure to revise your "electronic” version accordingly.

RENEWALS: UCRIHS approval is valid for one calendar year, beginning with the approval data
shown above. Projects continuing beyOnd one year must be renewed with the green renewal
form. A maximum of four such expedited renewals possible. Investigators wishing to continue a
project beyond that time need to submit it again for a complete review.

. REVISIONS: UCRIHS must review. any changes in procedures involving human subjects, prior

to initiation of the change. If this is done at the time of renewal, please use the green renewal
form. To revise an approved protocol at any other time during the year, send your written
request to the UCRIHS Chair, requesting revised approval and referencing the project’s lRBt
and title. Include in your request a description of the change and any revised instruments,
consent forms or advertisements that are applicable.

PROBLEMSICHANGES: Should either of the following arise during the course of the work,
notify UCRIHS promptly: 1) problems (unexpected side effects, complaints, etc.) involving
human subjects or 2) changes in the research environment or new information indicating
greater risk to the human subjects than existed when the protocol was previously reviewed and
approved. "'

If we can be of further assistance, please contact us at (517) 355-2180 or via email:
UCRIHSQmsuedu. Please note that all UCRIHS forms are located on the web:
http:/Mwmsueduluser/ucrihs
Sincerely

/ (JAM/w

Ashir Ku ar, M.D.
UCRIHS Chair

AK: br
00? Janelle M. Rowe

8200 Kensington Blvd. #719
Davison, Ml 48423

7"]

APPENDIX F

CONSENT FORM FOR HUMAN SUBJECTS PARTICIPATING IN AN
INVESTIGATION

Title of Investigation: Completing a Novel Task Under Different Sensory Input
Modality Conditions
Investigator: Janelle Rowe, MA (c)
Department: Graduate student in speech-language pathology at
Michigan State University
Address: 508 W. Ohio St.
Bay City, MI 48706

1. Purpose:

a. You are being asked to participate as a research subject in a
study of new Ieaming.

b. You have been selected as a possible subject in this study
because you are male, Caucasian, and between the ages of 18
and 21.

c. In the entire study, 24 people are being asked to participate.

d. From this study the investigator hopes to Ieam how new Ieaming
occurs.

e. Your participation in this study will take about one hour.

2. Potential Beneﬁts:
a. The potential beneﬁt to you for taking part in this study is an
increased understanding of how you Ieam.

3. Potential Risks:
a. There are no foreseeable risks associated with this study.

4. What the investigator will do:
a. The investigator will conduct an interview with you to ensure your
eligibility for participation in the study. Once eligibility is
determined, the investigator will teach you a new task.

5. What you will do:
3. Your role in the study is to merely listen to the investigator and
follow her instructions.

6. Conﬁdentiality:

a. The investigator will keep the information obtained in this study
conﬁdential within the limits of the law. Any information obtained
from this study that can be identiﬁed with you will remain
conﬁdential and will not be given to anyone without your

permission. The results of this study may be published or
presented at professional meetings, but the identities of the
research subjects will remain anonymous. You may obtain the
results of this research by contacting the investigator.

7. Your Rights: The right to say no and to withdraw:

a. Your participation in this research project is completely voluntary.
You have the right to refuse. You do not have to be a subject in
this study. If you refuse, you will not be contacted again. If you
agree, you may change your mind and say no at any time and
withdraw from the study.

6. If you have questions or concerns regarding yours or
participants’ rights in this study, or are dissatisﬁed at any time
with any aspect of this research, you may contact —
anonymously, if you wish - Ashir Kumar, M.D., Chair of the
University Committee of Research Involving Human Subjects
(UCRIHS) by phone: (517) 355-2180, fax: (517)432-4503, e-
mail: pcrihs@msu_.edu_, or regular mail: 202 Olds Hall, East
Lansing, MI 48824.

8. Costs and payment for being in the study:
3. There is no cost for being a part of this study. All subjects will be
reimbursed for their time at a rate of $12.00/hour.
b. If chosen, participants may receive class credit for their
participation.

9. The right to get more information:
a. If you have any questions, please ask the investigator. The
investigators phone number is 989-686-3165.

You will be given a copy of this form to keep.

10. Decision and Signatures:

YOU ARE MAKING A DECISION WHETHER OR NOT TO
PARTICIPATE IN THIS STUDY. YOUR SIGNATURE MEANS THAT YOU
HAVE READ THIS CONSENT AND THAT YOU HAVE AGREED TO BE A
SUBJECT.

 

 

Date Time (AM/PM)

 

Signature

 

Signature of Witness

 

Signature of Investigator

9.

Appendix G

Steps to Origami Project

. Position the paper vertically in front of you.

Fold the paper in half, bringing the top to the bottom and crease.
Take the top ﬂap and fold the paper up to the crease and crease the
fold.

Unfold

Turn the paper over.

Take the top ﬂap and fold the paper up to the crease and crease the
fold.

Unfold

Take the bottom left corner and fold it up to the crease in the middle of
the page.

Repeat the previous step with the remaining three comers.

10.Fold the top ﬂap along the middle crease.

1 1 .Tum the paper over.

12.Fold the top ﬂap along the middle crease.

13.Take the top ﬂap and fold it up, creating a rectangle with a ﬂat surface.

14.Tum the paper vertically.

15.Make a one-inch fold at the top of the paper, creating two pockets.

16.Insert the bottom comers into the pockets.

17.Fold the paper in half, bringing the left side over to the right.

APPENDIX H

Pre-experiment Demonstration of Vocabulary

Deﬁne the Following:

1 . Vertical

2. Crease

3. Flap

4. Rectangle

APPENDIX I

Auditory Group Instructions
Group One- Task Instructions

Today I will be teaching you a task. Listen to the instructions on the audiotape.
After all of the instructions, you will perform the task.

APPENDIX K

Auditory, Visual, and Tactual Group Instructions
Group Three- Task Instructions
Today I am going to teach you a task. Listen to the instructions on the

audiotape. After each instruction, do the step along with me. After all the
instructions you will perform the task.

Appendix L

Data Collection Sheet

Subject Number:
Group: Auditory-Verbal Auditory-VerbaWisual

Auditory-VerbalNisual/Tactile

Nonverbal Performance Measure:
Was subject_able to complete the task? Yes No

How many trials did it take to complete? 1 2 3 4 5

Please describe how you would instruct someone to do this task:

Comfort level with the task (1 being least, and 5 being most):
1 2 3 4 5

Is there something that would have made the task easier?

 

Subject Number".

86

APPENDIX M

CORRECT INFORMATION UNIT CALCULATION GUIDELINES

(Taken from Nicholas, LE, 8 Brookshire, RH. (1993). A system for
quantifying the inforrnativeness and efﬁciency of the connected speech of
adults with aphasia. go_umal of Speech and Hearing Research. 36. 338-350.)

Rules for scoring and counting words and correct information units
(ClUs)

Prior to determining which words should be included in counts of words and
correct information units, delete statements that are made before or after the
speaker performs the task or suggests that the speaker is ready to begin or
has ﬁnished the task and do not provide information about the picture(s) or
topic itself. Such statements generally are not produced consistently by
speakers from one session to another and are deleted to help stabilized
counts across sessions.

0 I hope I can remember how I did this before.
I’ll start by saying this.
I’m supposed to tell you about washing dishes.
I’m ready to start.
That’s about it.
I can’t say any more.
The end.

0 That’s about what our Sundays are like.
These statements should be grammatically separate from discussion of the
picture(s) or topic. The following ﬁrst statements by a speaker would be
included in the word count.

0 In the ﬁrst picture, the man is angry.

0 Well ﬁrst of all, there’s a couple ﬁghting.

0 Okay, there’s a man and a woman.

0 Well now, here’s a picture of a party.
This does not include commentary on the task or on the speaker’s
performance that occurs m the speaker is discussing the picture(s) or topic.
(See 1.22 for rules about commentary.)
Instructions: Draw a horizontal line through the middle of words that are to be
deleted prior to making decisions about the word count.

1.0. COUNTING WORDS

Deﬁnition: To be included in the word count, words must be intelligible in
context to someone who knows the picture(s) or topic being discussed.
Context refers to what the scorer knows about the picture(s) or topic and what
the scorer knows from the speaker‘s prior words. Words do npt have to be

87

accurate, relevant, or informative relative to the picture(s) or topic being
discussed to be included in the word count.

Instructions: Cross out with red Xs words that are not to be included in the
word count.

RULES FOR COUNTING WORDS

1.1. DO NOT COUNT THEOLLOWING
1.11. Words or partial words that are not intelligible in context to someone who
knows the picture(s) or topic being discussed.
0 He went to the frampi.
c That appears to be a norble.
- He had a st...sn...steak.
1.12. Nonword ﬁller (um, er, uh). (See 1.23 and 1.24 for a rule dealing with
ﬁller words and phrases, interjection, and informal terms.)
1.2. QOUNT THE FOLLOWING
1.21. All words that are intelligible in context. Count words that contain sound
substitutions, omissions, distortions, or additions if the word is intelligible in
context (hiscup for hiccup). If the incorrect production results in another real
word that does not appear to be the target word, it is still included in the word
count (paper for pepper).
1.22. Commentary on the task, on the speaker’s performance, or on the
speaker's experiences.
0 This is pretty hard.
0 I can’t think of that word.
a No, that’s not right.
1.23. Filler words and phrases (you know, I mean, okay). Do not count
nonword ﬁller. (See 1.12)
1.24. lnterjections (oh, oh boy, wow, golly, gosh, gee, aha, hmm) and
informal terms (uh-huh [afﬁrmative], un-uh [negative], nope, yep, yeah).
1.25. Common contractions or simpliﬁcations of words (gonna for going to,
sorta for sort of, em for them). Contractions (both standard [don’t, he’s]
and colloquial [gonna, sortal) are counted as two words.
1.26. Each word in hyphenated words (jack-in-the-box = 4 words).
1.27. Each word in numbers (twenty-two = 2 words, one hundred thirty-
four = 4 words, nineteen ﬁfty-ﬁve = 3 words).
1.28. Compound words as one word (pancake, cowboy).
1.29. Each word in proper names (Mary Smith, St. Paul, Mason City = 2
words each).
1.30. Count acronyms as one word (VA, VFW, TWA = 1 word each).

2.0. COUNTING CORRECT INFORMATION UNITS (ClUs)
Deﬁnition: Correct information units are words that are intelligible in context,

accurate in relation to the picture(s) or topic, and relevant to and
informative about the content of the picture(s) or the topic. Words do _n_o_t

have to be used in a grammatically correct manner to be included in the
correct lnfonnation count. Each correct lnfonnation unit consists of a single
word and only words that have been included in the word count can be
considered for inclusion in the correct information unit count.

Instructions: Put a diagonal penciled slash through words that are pgt to be
included in the correct information count.

RULES FOR COUNTING ClUs

2.1. DO NOT COUNT THE FOLLOWING
(In this section, words in bold print would po_t be counted as correct
information units.)
2.11. Words that do not accurately portray what is in the picture(s) or that do
not seem accurate in relation to the topic being discussed, such as incorrect
names, pronouns, numbers, actions, etc. If a word reﬂects regional usage
(such as calling the midday meal “dinner" in some areas), it is counted as a
correct information unit. If grammatical incorrectness would lead to
misunderstanding or uncertainty about the meaning of words, the
grammatically incorrect words would not be counted as correct lnfonnation
units. (See 3.12 for examples of grammatically incorrect words that would be
counted as correct information units).
a The girl is riding her bike. (The picture shows a girl with a bike nearby
which she may have been riding, but which she is not currently riding.)
a The girl is on a ladder. She fell. (The picture shows a boy on a stool
who is tipping, but has not fallen yet.)
0 The boys and girls are arriving. (The picture shows only one boy and
one girl arriving.)
If several people are involved in an action and only one of them is mentions,
the mentioned one is still counted as a correct information unit. This
constitutes an incomplete description but not an inaccurate one.
The ﬂy is arriving. (The picture shows a boy and a girl arriving.)
The _m_a_n_ drove away. (The picture shows a couple driving away.)
2.12. Attempts to correct sound errors in words except for the ﬁnal attempt.
c He put paper popper pepper on his food.
0 She saw her with her mass...mack. . .mask.
2.13. Dead ends, false starts, or revisions in which the speaker begins an
utterance but either revises it or leaves it uncompleted and uninfonnative with
regard to the picture(s) or topic.
My si...no no not my sister...my fa...with my wife.
He goes over to her and puts his wants to give her a hug.
He looks out and sees that she had the car ran into the tree.
In the nose in the mouse in the house.
We go to a party no I mean a movie.
If an utterance is incomplete, but some information about the picture(s) or
topic has been given, count that information.
o The kitchen window was...

In this example, the words _t_he k_itchen was would be counted as correct
information units (if they meet the other criteria). Even through the entire
statement was not completed, the words are informative.
Words that express some legitimate uncertainty or change in perception
about characters, events, or settings in a picture are counted as correct
information units (if they meet the other criteria). See 2.18 for further
examples.
0 Her (_t_aLd or maybe a neighbor was in the tree.
a From the looks of the candles, he must be fpgr. No there is a_nother
candle on the table sp he must be ﬁve years old.
2.14 Repetition of words or ideas that do not add new information to the
utterance, are not necessary for cohesion or grammatical correctness, and are
not purposely used to intensify meaning.
0 The blue truck was blue.
0 The restaurant was a new one. It was a new restaurant.
0 She was cleaning washing the dishes.
Such repetition of words or ideas can be separated by other counted words.
0 The mother was very angry. The daughter was crying. The mother
was very mad.
Exceptions:
(a) If the repeated words or ideas are necessary for cohesion, they are
counted. She went to the store. The §t0_r_e_ was closed.
(b) If words are repeated to achieve effect or to intensify a statement they are
counted.
0 The girl was vegy, vegy sad.
0 They were ﬁghting, really ﬁghting.
(c) If repeated words are used to expand on previous information, they are
counted.
0 He put on a ﬁne left shoe.
0 There were some people...a mpg and a woman.
2.15. The ﬁrst use of a pronoun for which an unambiguous referent has not
been provided. Subsequent uses of the pronoun for the same unspeciﬁed or
ambiguous referent are counted as correct information units ( if they meet the
other criteria).
0 She (no referent) was doing the dishes. I think _S_h§ was day-
dreaming.
If an inaccurate referent is provided but it is clear that a pronoun refers back to
it, the pronoun would be counted as a correct information unit.
a The fox (inaccurate referent) ate some of the cake and i_t was hiding.
2.16. Vague or nonspeciﬁc words or phrases that are not necessary for the
grammatical completeness of a statement and for which the subject has not
provided a more speciﬁc word or phrase.
The mother is drying one of those things.
She gave him some stuff.
He put something up to the tree but that one knocked it down.
We had pancakes or scrambled eggs or something like that.

Of

o I wash the glasses and plates and so on.

The words ”here” and “there” frequently fall into this category.
Here we have a boy.
This here boy is crying.
That mother there is doing dishes.
There is a eat here and a dog there.
The mother is there.
She put them over here.
She has a bike there.
The cookies were up there.
The following are examples of uses of “here” and “there” that are necessary
for the grammatical completeness of the statement and cannot be replaced by
a more speciﬁc word. These uses of “here” and “there” would be counted as
correct lnfonnation units.

0 There is a boy.

0 El_e_rp comes the same couple.
The following is an example of a nonspeciﬁc word that is preceded by a clear
referent and would be counted as a correct information unit.

0 The boy opened the cupboard. The cookies were up Mp.
2.17. Conjunctive terms (particularly so and then) if they are used
indiscriminately as ﬁller or continuants rather than as cohesive ties to connect
ideas.

0 There is a man. Then there is a woman and then a cat.
When used cohesively, “then” indicates the temporal order or sequential
organization of things or events.

0 She had lunch and Mpg she went to the store.

0 When you go into my house you see the living room ﬁrst, they) the

dining room, then the kitchen.

When used cohesively, “so” indicates a casual consequence.

a He was thirsty §p he drank some juice.

a The mother was after the dog g2 the boy was crying.
2.18. Qualiﬁers and modiﬁers if they are used indiscriminately as ﬁller or are
used unnecessarily in descriptions of events, settings, or characters that are
unambiguously pictured. The following examples concern unambiguously
pictured information.
Apparently this is a kitchen.
Evidently the boy is on a stool.
I think that the cat is in the tree.
It looks like the man is up in the tree too.
The boy is sort of crying and the dog is kind of hiding.

0 Of course, the woman left in a huff.
When used infonnatively, qualiﬁers and modiﬁers suggest legitimate
uncertainty on the part of the speaker about events, settings, or characters
portrayed in the picture(s) or modify associated words in a meaningful way.
The following examples concern ambiguously pictured information.

 

Apparently this is a mother and her two children.
I think she is his sister.
It looks like he gave them the wrong directions.
She must be daydreaming.
He might be the girl’s dad or mame he’s a neighbor.
He is the father or a neighbor. I don’t know which.
He looks sort of sad.

0 Evidently they went around in a circle.
2.19. Filler words and phrases (you know, like, well, I mean, okay, oh well,
anyway, yeah), lnterjections when they do not convey lnfonnation about the
content of the picture(s) or topic (oh, oh boy, wow, gosh, gee, golly, aha,
hmm), and tag questions (it is really smashed up, isn’t it).
2.20. The conjunction “and” “And” is never counted as a correct information
unit because it is often used as a ﬁller and we have found that its use as ﬁller
cannot be discriminated reliably from its use as a conjunction.
2.21. Commentary on the task and lead-in phrases that do not give information
about the picture(s) or topic and are not necessary for the grammatical
completeness of the statement.

0 These pictures are poorly drawn.

a This is kind of hard.

0 In the first picture...

0 As I said the last time, she was upset.
2.22. Commentary on the subject’s performance or personal experiences.

a I can’t think of the name of that. -
I can’t say it.
No, that’s not right.
My kids were always getting into trouble too.
My wife and I used to ﬁght like that.
They are ﬁghting but I don’t know why.
Some statements that contain personal information may be appropriate in
procedural and personal information descriptions and, in such cases, they
would be counted as correct lnfonnation units (if they meet the other criteria).
See 3.16 for embellishments that are counted as correct information units.
See previous page for statements that are deleted before beginning the word
and correct information unit counts.
3.1. @UNT THE FOLLOWING (if they meet all other criteria)
(In this section, words in bold print would be counted as correct information
units.)
3.11. All words (nouns, adjectives, pronouns, verbs, adverbs, articles,
prepositions, and conjunctions) that are intelligible in context, accurate in
relation to the picture(s) or topic, and relevant to and informative about the
content of the picture(s) or topic.
3.12. Words do not have to be used in a grammatically correct manner to be
counted. Words that violate standard English grammar rules concerning
appropriate verb tense and form, agreement in number between subject and

92

predicate, agreement between articles and nouns, incorrect use of articles,
and appropriate singular and plural forms are counted as correct lnfonnation
units unless these violations would lead to misunderstanding or uncertainty
about the meaning of the words.
See 2.11 for examples of words that would not be counted as correct
information units.
The firemans are comin.
The ﬁremen ain’t rescued them yet.
Put some stamp on it.
The friends is here.
He don’t look very happy.
3.13. Production of a word that results in another English word, if the
production would be intelligible as the target word in context.

a He is standing on a school and it is tipping over.
3.14. The ﬁnal attempt in a series of attempts to correct sound errors.

0 He went to the musket...minuet...market.
3.15. Informal terms (nope, yep, uh-huh) when they convey information about
the content of the picture(s) or topic.

0 She said “Uh-huh, I’ll do it.”
3.16. Words in embellishments that add to the events portrayed in the
picture(s) or express a moral, if they are consistent with the situation or events
portrayed. Words that express some legitimate uncertainty about characters,
settings, or events in the pictures.

0 He’s going to get hurt and his mom is going to be angry.
Some days everything seems to go wrong.
That looks like a nice way to spend a summer day.
Sooner or later cats usually get stuck up a tree.
Mothers sometimes get distracted and don’t notice things.

0 This is the one about the accident-prone family.
However, see 2.22 for examples of extraneous commentary that may
resemble embellishments, but are not counted.
3.17. Verbs and auxiliary verbs (is, are, was, were, to, has, have, will,
would, has been, etc) as two separate correct information units - one for the
auxiliary verb and one for the main verb.

0 His mom is going to be angry. (Each word in bold print is a correct

information unit.)

3.18. Contractions [both standard (won’t) and colloquial (gonna)] as two
correct information units.
3.19. Each word in hyphenated words (father-in-law, good-bye).

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92

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